apa-nm.org · PLAN HEALTH. 4. NewMexico. Authors: Dana Gorodetsky, Cecilia McKinnon. CONTRIBUTORS:...

Advancing Healthy Communities; Building local capacity for integrating planning & public health.

Healthy Communities;

2017 assessment

PLAN HEALTH NewMexico4


Authors: Dana Gorodetsky, Cecilia McKinnonCONTRIBUTORS: Erick Aune, James Foty, Josh Johnson, Desiree Valdez

Design and Editing:suOm Uheri Francis

Authors & Contributors:

APA-NM board, for providing overall guid-ance and support on this project and man-aging the grant

Sites Southwest, for providing technical assistance and guidance, and making mean-ingful contributions to this project

Staff and representatives from the follow-ing organizations, coalitions, agencies, and networks generously contributed their time and insights at various points throughout the project (listed in alphabetical order):

Acknowledgments

• Bernalillo County Community Health Council

• Bernalillo County Planning and Develop-ment*

• Bike ABQ

• Carlsbad Schools*

• City of Carlsbad Planning Department*

• City of Española Planning*

• City of Las Cruces Planning, Economic Development, Public Works*

• City of Roswell Planning Department*

• City of Santa Fe Planning and Housing*

• Con Alma Health Foundation*

• Consensus Planning*

• Doña Ana Communities United*

• Farmington MPO

• First Choice Community HealthCare, South Valley Community Commons

• Groundwork Studio New Mexico*

• Health Equity Working Group*

• Health Matters NM

• Healthy Here

• International District Healthy Communi-ties Coalition*

• Lea County Health Council*

• Lincoln County Health Council*

• Los Alamos County Community Develop-ment*

• McKinley County Collaborative for Health Equity*

• Mental Health Resources New Mexico*

• Mid-Region Council of Governments*

• New Mexico Alliance of Health Councils (andspecificCommunityHealthCouncils)

• New Mexico Breastfeeding Alliance*

• New Mexico Complete Streets Leader-ship Team

• New Mexico Community Data Collabo-rative*

• New Mexico Department of Health, Health Promotion Specialists from differ-ent regions*

• New Mexico Department of Transporta-tion Planning Bureau

• New Mexico Health Equity Partnership*

• New Mexico Public Health Association

• New Mexico Public Health Institute*

• New Mexico Resiliency Alliance*

• New Mexico Social Justice Institute*

• OptumHealth New Mexico*

• Phillips Foundation*

• Portales Public Health*

• Presbyterian Health Care Services Center for Community Health*

• San Juan Collaborative for Health Equity*

2

3PLAN HEALTH NewMexico4

• San Miguel County Health Equity Steering Committee*

• Santa Fe Art Institute*

• Santa Fe Community Foundation*

• Santa Fe Metropolitan Planning Organiza-tion*

• Sheep Springs Backyard Garden Project*

• Southwest Center for Health Innovation*

• Taos Pueblo*

• Town of Mesilla*

• United Way of Carlsbad*

• University of New Mexico HIVE Collabora-tive(Health,Inclusion,Vibrancy,Equity)*

• University of New Mexico Prevention Re-search Center*

• University of New Mexico School of Archi-tecture and Planning, including Indigenous Design and Planning Institute*

• VIVA Connects*

*Indicates organizations represented at re-gional events and/or the roundtable event


TABLE OF CONTENTS

A Planner’s Perspective

Public Health Perspective

by Erick Aune

by Desiree Valdez

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7

AboutPlan4Health New Mexico

APA-New Mexico Chapter

APA Planners4Health Initiative

Foreword

8

Executive Summary 9Introduction 15Background

Assessment

16

17

Context 19Public health and planning

context in new mexico

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23

Methods and Results 27Assessment methods

ASSESSMENT RESULTS

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#1 What are the key issues across New Mexico related to planning and public health, and how do these relate to the health of our communities?

#2: What are the key assets and resources that currently enable planners, public health professionals, and other stakeholders to collaborate on integrated approaches to community health?

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37

#3: What are the key challenges and barriers? 43

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4


viva connects

id+PI indigenous design and planning institute at the university of new mexico

new mexico community data collaborative

Bernalillo county greenprint project

Healthy here

DOÑA ANA COMMUNITIES UNITED CHAPARRAL lisa drive connectivity engagement

FIRST CHOICE COMMUNITY HEALTHCARE: SOUTH VALLEY COMMUNITY COMMONS

University of New Mexico School of Architecture + Planning, Master of Science in

Architecture Health + Built Environment Track

Santa fe art institute

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55

Case Studies

Conclusion & Recommendations 83conclusion

pressing questions and key recommendations

84

85

Looking Forward

51

59

62

65

69

73

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# 1 Specialized Communication 85# 2 Organizational Commitment 86# 3 Capital and Financing 86# 4 Stability and Sustainability 87# 5 Equity and Accessibility 88

# 6 Policy 89# 7 Networks 90# 8 Community Engagement 91

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TABLE OF CONTENTS


A Planner’s Perspective by Erick AuneTransportation Planner, Santa Fe Metropolitan Planning Organization and President, APA-New Mexico Chapter

AsanurbanandtransportationplannerworkinginNewMexico,Iamstruckbytheinfluenceand impacts my fellow colleagues have regarding the development of communities, including tribesthroughoutthestate.Workinginavarietyofdisciplines,fields,organizationsanddiversecommunities, one cannot simply categorize the work in planning as a singular practice. The complexities surrounding each position combined with individual skill sets and experiences provide for rich experiences and unique challenges based on the needs and demands of a community and its landscape.

Community health can be measured in many ways. Without question, the decisions, invest-ments and prescriptive regulations shaping our built and natural environment directly impact health and quality of life. As an example, New Mexico health outcome data provided by the New Mexico Environmental Public Health Tracking Program helps us better understand the heavy burdens our communities shoulder as a result of these decisions.

Asplannersendeavortoinfluencepolicyanddecisionmakinginwaysthatmovetheneedlecloser to healthful decision making, we are not alone. Professionals committed to the ad-vancementofpublichealth--whetherwiththeDepartmentofHealth,non-profitorcommunityorganizations--are working alongside us, and more than ever we need their expertise, support and critical thinking.

This assessment is an acknowledgement of the results of the good work already occurring when planning and public health align themselves around common goals. This assessment is also an honest acknowledgement of the gaps, silos, missed opportunities and even conscious decisions to avoid collaboration that exist for many reasons. With the Planners4HealthNM ef-fort and assessment we believe we can break down the barriers that hinder collaboration and move our collective practices toward healthful decision making. We hope you do too.

Foreword

6


Public Health Perspective by Desiree Valdez, Health Promotion Program, Northeast Region, Public Health Division, New Mexico Depart-ment of Health.

Public Health & Planning: Translating and Combining Our Efforts for Better Health Outcomes

Public health is community health. New Mexico’s community health outlook is unique: we have a wealth of cultural and geographic diversity, as well as an intense scarcity of resources and boots on the ground to get things done. The work of public health professionals is com-prised of many different strategies and interventions because our populations and communi-ties are complex and have a variety of health concerns that must be addressed.

To better understand the health of a community, public health looks at the intersecting fac-ets informing health outcomes: the social determinants of health. Food access, transportation, education, social support, public safety, and the built environment are just a few examples of the social determinants of health. The built environment is where public health can provide useful input to planning. The people who reside and work in New Mexico have a right to a safe, clean, and accessible built environment. When the built environment is working well in a community, it provides opportunities for people to overcome health barriers and to have bet-ter health outcomes. Due to our state’s current rates of diabetes, obesity, and access to health-care, an innovative and culturally competent built environment is more important than ever.

Projects like Planners4Health are key in offering a chance for public health professionals and planners in New Mexico to better understand the crucial roles we each play in their commu-nities.Bydovetailingourgoals,wecanfigureoutcreativewaystoenhanceandsupporteachother’scommunityprojects.Thefirststepsareassessingwhatresources,people,andtoolswecurrently have access to and what tools we need to acquire to be effective in our work, while ensuring at the center of the planning process is a sincere acknowledgement and incorpora-tion of the history, culture, and people whose lives we are impacting.


AboutPlan4Health New Mexico

Plan4Health New Mexico was a six-month initiative in 2017 to build local capacity for in-tegrating planning and public health with the overall goal of creating stronger, healthier com-munities. The American Planning Association (APA)NewMexicoChapterreceiveda$50,000grant through the APA Planners4Health initia-tive to promote greater coordination between planners, public health professionals, and other key stakeholders across the state. To do so, the chapter worked to bring together key stakehold-ers, leverage existing healthy community initia-tives and efforts underway, and share planning and public health information.

APA Planners4Health InitiativeThrough an overarching collaborative strategy

that brings together members of APA and the AmericanPublicHealthAssociation(APHA),thePlan4Health project is building local capacity to address population health goals and promote the inclusion of health in non-traditional sectors. The Planners4Health initiative marks the three-yearculminationofAPA’s$9millionPlan4Healthprogram that works to combat two determinants of chronic disease – lack of physical activity and lack of access to nutritious foods. Funding for the initiative is provided through a grant from the Centers for Disease Control and Prevention (CDC)

APA-New Mexico ChapterThe New Mexico Chapter of the American

PlanningAssociation(APA-NM)isanorgani-zation of professional planners and planning officialswhoserveNewMexico’scommunitiesin many ways, at all levels of government, the privatesectorandnot-for-profitorganizations.Itsmission is to improve and promote the quali-ty and standards of planning in New Mexico. Through the Planners4Health initiative, APA-NM is broadly sharing knowledge and resources on building coalitions with public health profession-als and more strongly integrating public health into local and regional planning practices.


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9

Executive summary


OverviewDuring the course of six months in 2017, APA-

NM carried out the Plan4Health New Mexico initiative with funding from the American Plan-ningAssociation(APA).TheoverarchinggoalofPlan4Health is to promote better coordination between planners and public health profession-als at the state level, and to enable coalition building and information sharing to help com-munities more easily support and implement healthy living choices. This is important because New Mexico is facing many health and planning challenges, including slow population growth (andlossinsomeareas),multi-generationalpoverty, and poor health outcomes – disparately so for some residents. Many of these challenges are directly linked to the social determinants of health in communities, which planners and pub-lichealthofficialshaveanopportunitytoaddressthrough policies, practices, and projects. This assessmentseekstofindwaystoidentifykeyopportunities for advancing the work of coali-tions of planners and public health professionals across the state.

Report StructureBackground and key activities of the initiative:

• Conducting an online survey

• Hosting four regional events

• Creating web-based materials (storymap andwebsite)

• Engaging with partners and other stake-holders

• Producing an assessment report

• Disseminating information and building capacity

• Hosting a statewide roundtable event

Key questions addressed:

• What are the key issues across New Mex-ico related to planning and public health, and how do these relate to the health of our communities?

• What are the key assets and resources that currently enable planners, public health professionals, and other stakeholders to collaborate on integrated approaches to community health?

• What are they key challenges and barriers?

• What are the best practices and potential models to integrating planning and public health and improving community health outcomes?

• Looking ahead, what are the key opportu-nities for advancing the work of coalitions of planners and public health profession-als?

Summarizing Key FindingsKeyCommunityHealthIssuesidentifiedby

professionals accross the state:

child care

economic develop-ment

homelessInfrastructure

& design that affects physical a c t i v i t y

ACcESS TO HEALTH CARE

TRAILS

socialjusticeLACK OFFUNDING

HEALTHFOOD ACCESS

SUB-STANCEABUSE

MENTAL HEALTH

S T R E S S

E N V I R O N M E N TA L J U S T I C E

ROADS

recreational facilitiesracism

gentrificationeconomicissues

POVERTY

community understanding

LEADERSHIP/ COMMITMENT

NEED TO COLLABORATE

chronic disease

holisticapproaches

safety

sociocultural fit

L O W D E N S I T Yp o l i c y

ageism

addiction

Fig.1 Statewide community health issues

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Assets And ResouRces

Networks, CoalitioNs, PartNers • Relationships with allies help develop and

support shared goals and commitments

• Partners lend intangible support (credibility, visibility,etc.)andtangiblesupport(fund-ing,in-kind,technicalassistance)

• Networkmembersfillgapsincapacityandenable implementation, and also allow for sharing information and best practices

• Non-traditional partners are especially important for new ideas and resources

iNdividual CommitmeNt

• Individuals, not always the organizations in which they operate, are the most powerful assets

• Personal relationships are often leveraged more than institutionalized processes (downsidestothistoo)

• People who operate from abundance (ratherthanscarcity)mindsetcanbelead-ers

• Importance of the commitments that indi-vidual community members make

PoliCies aNd regulatioNs

• These serve more as enablers than barriers to integrated approaches to healthy com-

• Examples: adoption of Complete Streets approach as policy across the state; adop-tion of Health in all Policies as framework across the state

• Grassroots engagement as important driv-er of positive policy change

• Establishing ways to evaluate impacts of policies and promote accountability has been limited, but positive

data

• Important assets include data sets, reports, platforms, and trainings – particularly data sets that are available on a neighborhood level and platforms that help visualize data for better communication

• All of these help understand issues in new, holistic ways and serves as a bridge be-tween planning and public health profes-sionals, and with additional stakeholders

• Gathering and sharing data in locally-rele-vant ways and with local stakeholders is key

• Some awareness and use of data between sectors, but this is still limited

And to a lesser extent:

FuNdiNg

Overall considered a limitation across the state, but many acknowledged that some local funders are responsive to local needs

CommuNiCatioN Depending on the context, low-tech face-to-

face communication forums vs. social media were cited as assets

Cultural ComPeteNCy Although most thought more could be done

in this realm, some highlighted the good work in planning and implementing community health initiatives in culturally-appropriate ways.

ORGANIZATIONAL FUNDING

REGULATION

POLICY

NETWORKS

DATA SETS

LEADERSHIP

SPECIFIC PARTNER

OTHER

ORGANIZATIONAL COMMITMENT

POLICY

NETWORKS

DATA SETS

LEADERSHIP

OTHER

FUNDING

SPECIFIC PARTNER

0 10 20 30 40 50 60

REGULATION

Which of the following currently enable you to integrate health and planning in your work?

1) How are these enablers?

2) Which are most important?

3) Specific examples?

STATEWIDE

DISCUSSION: ASSETS & REsOURCES

Fig.2 Statewide assets and resources


Language and CommuniCation methods

• Lack of common language (use of jargon, acronyms)andcommonunderstanding(gaps in technical concepts, tone mis-match)betweendifferentprofessionalsandother stakeholders.

• Silos in organizations that prevent transpar-ency, clarity, and information sharing

• Lack of forums to meet, share ideas, ex-change information, and expand networks

• Basic communication can be a challenge in many parts of the state given long distanc-es and limited communications infrastruc-ture

laCk oF leadershiP aNd orgaNizatioNal CommitmeNt

• Organizations and individuals operating from a scarcity mindset: limits innovation, creativity, and even basic effectiveness

• Individualsoutsideofspecificrolesarenot empowered to act as leaders, and are either told or feel that they cannot operate out of a limited purview

• Local leadership acting in territorial, pa-rochial ways and breeding competitive, rather than cooperative attitude across communities and regions

• Disconnect between federal/state leaders who set priorities and standards, and actual local needs

FuNdiNg aNd CaPaCity limitatioNs

• Overall funding limitations across the state, particularly for things not considered basic services or not fully proven (such as new, innovativeapproaches)

• Nature of available funding, for instance effort-intensive competitive grant-seeking process, imbalanced power dynamics with funders, funding priorities mismatched to local needs

• Lack of capacity to hire and develop staff adequately, leading to gaps in services and burn-out

• Lack of local workforce, and turnover of staff

Network shortComiNgs

• Limitations in the composition, scope, and dynamics of networks across the state

• Over-reliance on the same individuals and organizations in networks, leading to missing perspectives and burn-out or disengagement

• Some areas have strong local networks, but are disconnected from (or disregarded by)statewideorbroadernetworks

• Paralysis or inertia within networks, in-volving misalignment of priorities, lack of capacity, or breakdown of trust



FUNDING

REGULATION

POLICY

NETWORKS

DATA SETS

LEADERSHIP

SPECIFIC PARTNER

OTHER

0 10 20 30 40 50 60

Which of the following are currently lacking but would help you to integrate health and planning in your work?

DISCUSSION: GAPS & CHALLENGES 1) How are these limiting?

2) How would they be enablers?

3) Which are most important to prioritize moving forward?


STATEWIDE

chAllenges And BARRieRs:

Fig.3 Statewide challenges and barriers

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cAse studies

• VIVA Connects: Joint community-academ-ic initiative, bridging research and imple-mentation.

• New Mexico Community Data Collabora-tive: Resource that enables stakeholders across the state to access and understand data, and builds community capacity to move data into action.

• UNM Indigenous Design and Planning Institute: Introduces traditional indigenous frameworks into community planning and community-initiated visioning processes, along with educational mission which encompasses community members and academics, policymakers, and professional practitioners alike.

• Santa Fe Art Institute: Partnerships and capacity building related to the intersec-tion of art, health and land use/built envi-ronment.

• First Choice Community Healthcare South Valley Community Commons: Health care organization driving local transformation of built environment and more to address social determinants of health and improve overall community health.

• Doña Ana Communities United Chapar-ral Lisa Drive Connectivity-Engagement Project: Practicing and institutionalizing a new approach to community engagement in land use planning.

• Bernalillo County Greenprint Project: Community-led and data/mapping-driven assessment of priority open space and conservation areas in Bernalillo County, to serve as tool for decision makers and basis of collaboration for multiple agencies and organizations.

• Healthy Here: Collective impact mod-el involving ongoing commitment and engagement by a number of institutional partners(granteesandsub-grantees)thatcomplement one another in resources, assets, and networks, and work toward shared goals.

• UNM School of Architecture and Planning, Master of Science in Architecture, Health + Built Environment Track: Training a new generation of practitioners who have a sol-id background in both design of the built environment and in public health to apply in both their research and practice.

CommuNity eNgagemeNt methods

Key perspectives are not heard or intentionally de-legitimized, and therefore community prior-itiesarenotaccuratelyreflectedinplans,proj-ects, policies

PoliCy aNd regulatioN

Some policies are effective but not enforced, restrictive or harmful to integrated approaches, or not responsive to feedback and changing priorities over time.

See the results section for more details on each, including regional variations.


Summarizing Key RecommendationsThis assessment includes a series of rec-

ommendations – professional practices and potential projects and activities alike – that strive to galvanize collaborative efforts that can lead to successful implementation by leaders inplanning,publichealth,andanyotherfieldinvolved in community health. The combination of stakeholder input and an analysis of successful case studies reveals a set of principles that ties together a list of recommendations. The exis-tence of organizations, programs, and dedicat-ed individuals in New Mexico working toward healthy communities is exceptional, and efforts toleverageexistingworkbroadensbenefitsand positive impacts to communities across the state. This assessment reveals a number of themes that lead to the recommendation of core concepts in advancing healthy communities work – see recommendations section for more specifics.Theseconceptsinclude:

• Thoughtfully networking and communica-tion across sectors and stakeholder types;

• Investing in organizational commitment around staff and partnership development;

• Leveragingexistingcapitalandfinancingopportunities through the lens of coopera-tive initiatives;

• Acknowledging the barriers to equity, and developing policies and practices that build bridges;

• Knowing well the communities we all work to serve, and engaging each in appropri-ate, relevant ways; and

• Overcoming myths and assumptions that reinforce institutional and cultural barriers for effective and positive change.

ConclusionWe are at a pivotal moment in New Mexico

to leverage the Plan4Health NM initiative and findingstobuildcollaborativeeffortsinlinewiththe principles listed above. The recommenda-tions detailed in full in this report may begin to addresssomeofthechallengesidentifiedinthisassessment, and further leverage existing assets and resources. With the multiple and diverse perspectives represented in these recommen-dations, we hope that any stakeholder in any part of the state will feel empowered to act on any of the ideas in a way that is most appropriate for their local context. In this way and through a commitment to further promoting integrated planning and public health initiatives, we be-lieve improvements in community health can be made across the state.

visithttps://plan4healthnm.com

for online sources related to planning and public health

locally and nationally including ESRI storymaps

and potential partners.

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Introduction


BackgroundPlan4Health New Mexico

During the course of six months in 2017, the American Planning Association-New Mexi-co Chapter carried out the Plan4Health New Mexico initiative with funding from the American PlanningAssociation(APA)workedto:identifypotential partners; leverage existing healthy community initiatives and efforts underway; share planning and public health information; and bring together key stakeholders.

Key activities included:

• Conducting an online survey: planners, public health professionals, and other key stakeholders provided their input on the key healthy community design issues in their communities, as well as the key enablers and barriers to working collabora-tively to address them.

• Hosting regional events: Plan4Health NM convened health and planning stakehold-ers during four events to provide more nu-anced and detailed perspectives on local issues and opportunities, and to strength-en and expand their professional networks.

• Creating web-based materials: at the start of the initiative, Plan4Health NM launched a website. In addition to sharing informa-tion during the course of the initiative, the website will also serve as an enduring hub for information and resources related to planning and public health, both locally and nationally. Among these resources are two storymaps, created as part of this initiativetoconveyfindingsandrelatedissues, developed in partnership with the New Mexico Community Data Collabora-tive(NMCDC).Thewebsite,includingallofthese resources, can be found at: https://plan4healthnm.com

• Engaging with partners and other stake-holders: the Plan4Health NM team also met with many stakeholders individually and in small groups over the course of the project to identify potential partners for the initiative’s activities and gather infor-mation, especially on local initiatives that could serve as case studies to highlight best practices and potential collaboration opportunities.

• Producing the assessment: all of these activities have informed this report, which serves as an assessment of the current landscape and future opportunities for integrating planning and public health ap-proaches across the state of New Mexico.

• Disseminating information and building capacity: by sharing resources and lessons learned during the course of this assess-ment, Plan4Health NM endeavors to build local capacity for integrating planning and public health approaches to improve com-munity health and wellbeing. Plan4Health hosted a roundtable event in Albuquerque in July to share these results and conduct a workshop that built the capacity of stake-holders from planning and public health

visithttps://plan4healthnm.com

for online sources related to planning and public health

locally and nationally including ESRI storymaps

and potential partners.

16


tousemappingtools(withNMCDC)andwork collaboratively. Moving forward, APA-NM will maintain the Plan4Health NM website as an active repository for resourc-es,andwillsharefindingsandresourcesthrough chapter activities, statewide events, and conferences involving APA chapters from other states to promote broader information sharing.

• NewMexicoResiliencyAlliance(NMRA)funding:ItsflagshipfundingprogramistheResilient Communities Fund, which sup-ports community development projects with a focus on healthy community design and public infrastructure, and resilient com-munity initiatives. As the mission and grant program is well-aligned with the purpose of our initiative, Plan4Health New Mexico committed funds to two grants awarded by the NMRA to Doña Ana Communities United and Carrizozo Works. Learn more about these projects and others here: http://www.nmresiliencyalliance.org/resil-ient-communities-fund.

This report, as well as resources gathered and story maps generated on the Plan4Health New Mexico website, are the key outputs of this initiative.

Assessment: why, for whom, and intendedbenefits

This assessment offers an opportunity to recognize current organizations, agencies, co-alitions, alliances and other cooperative efforts throughout New Mexico.

Efforts by planning and public health profes-sionals, as well as other stakeholders, increasing-ly involve similar goals and objectives related to advancing community health, and health equity in particular. By highlighting existing innovations and best practices, this assessment aims to in-spire and enable those involved with initiatives at various stages to connect with one another and advance their shared goals. The assessment also identifiesdatasourceseachcohortisusingtoinform program strategies, project funding and educational material. In all of this, the assess-ment aims to be illustrative, rather than claiming tobefullycomprehensiveinitsfindings.

This assessment offers a number of potential benefitstoplanners,publichealthprofession-als, and community leaders who are seeking to improve community health. These include:

• Identificationofcasestudiesthatcanserveas inspiration and share information about leveraging resources, technical assistance and funding for communities and neigh-borhoods in areas of critical need.

• Future development of pilot projects that include new partnerships with plan-nersandpublichealthofficialsthatcouldpotentially become replicable in nature for New Mexico.

• Informing legislators and policy makers about the issues facing local residents, and what types of investments may maximize community goals.

• Allowing community leaders to access public health data and planning resources in new ways to increase their resiliency and independence.

• Introduction to collaborative networks and potential partnerships upon which to build.

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Context


Public Health & PlanningHistory and OverviewAlthoughinmanywaysthefieldsofpublic

health and planning are distinct, there is much that already connects – or has the potential to link – professionals in these two areas in terms of common goals, strategies, and ways of working. In fact, the origin of the urban planning profes-sion can be traced to nineteenth-century public health initiatives, including tenement housing reforms and the construction of urban water supply and sanitation systems. Since then, the work of planners and public health professionals has intersected in a number of ways. While some of the early synergies may have been primarily in reaction to public health crises, there is in-creasing recognition of and buy-in for proactive, collaborative approaches focused on prevention that can improve the health and wellbeing of communities. As we have seen over time – and through the Plan4Health New Mexico initiative – the professions share many of the same ultimate goals, particularly regarding community wellbe-ingandvibrancy.Itcanbedifficultforstakehold-ers at various levels to identify and implement integrated, collaborative approaches, but doing so can leverage often limited resources for greatercommunitybenefit.Byseekingtomakelinkages and take an integrated approach rather than thinking only about what each profession on its own can bring to the table, community needs can be addressed in a more holistic, im-pactful way.

Key current issues

heAlthy community design

One shared concept between planning and public health is that of “healthy community design.”Whilethereisnosingledefinition,theCenters for Disease Control and Prevention (CDC)explainshealthycommunitydesignaslinking the traditional concepts of planning (such as land use, transportation, community facili-ties,parks,andopenspace)withpublichealththemes (such as physical activity, public safety, healthy food access, mental health, air and water quality,andsocialequityissues).Inessence,healthy community design is about understand-ing how the design of a community can improve or harm residents’ health, and planning so that the healthy choice is the easy choice for all, with the goal of making a community healthier for everyone.

For example, research suggests that planning and community design characteristics such as transportation infrastructure, land use patterns, zoning, and other aspects of the built envi-ronment can have an impact on a number of community health issues including: obesity, car-diovascular disease, level of physical activity, re-spiratory and mental health, waterborne diseas-es, hazardous materials exposure, social equity, communitysafety(accidents,injuries,andcrime),social capital, and more. Some of these relation-ships have been recognized and understood for decades, while some are less well known. For instance, the effects of land development on air and water quality, and the human health implications of exposure to related pollutants or hazardous materials, has been documented and incorporated into health and planning work for

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some time. Alternatively, links between the built environment and mental health – for example the positive psychological effects of living near trees and greenspace, or the mental health implications of residents’ perception of safety in a neighborhood – have emerged more recently and are still not well understood. Further, an emerging public health issue across the United States is an epidemic of opioid addiction, which is tied to mental health, economics, and other issues. While there is much public dialogue and varying degrees of action among different public and private actors to address this issue, a clear idea of how those in the planning profession can bring their tools, approaches, and resources to bear on this pressing issue is still needed.

In order to maximize community health ben-efitsforallresidents,agrowingnumberofresources and a body of best practices is being generated and made available by a number of organizations. As one example, the EPA pub-lished a set of healthy community design princi-ples that can be leveraged to address many of the key issues facing communities and advance shared goals of planners, public health profes-sionals, and other stakeholders. These are:

• Mixed-land use that supports short dis-tances between homes, workplaces, schools, and recreation so people can walk or bike more easily to them

• Public transit to reduce the dependence on automobiles

• Pedestrian and bicycle infrastructure, including sidewalks and bike paths that are safelyremovedfromautomobiletraffic,and clear, easy-to-follow signage

• A community that is accessible and socially equitable to all residents regardless of age, ability, income and cultural custom

• Housing for different incomes and stages of life

• Green space and parks that are safe and easily accessible by walking or biking

• Safe public spaces for social interaction

• Fresh, healthy food outlets

Someofthebenefitsthesehealthycommunitydesign principles aim to promote include:

• Improved air and water quality

• Loweredriskoftraffic-relatedinjuries

• Ease of including physical activity into everyday life

• Increased access to healthy food

• Increased social connectivity and sense of community

• Ensured social equity for all community members

• Promotion of good mental healthSource: Environmental Protection Agency. Low-Impact Devel-

opment(LID)[online].2010July28.AvailablefromURL:http://

water.epa.gov/polwaste/green/.

collABoRAtion: BARRieRs And oppoRtunities

A recurring theme in this work is the impor-tance of collaboration between planners, public health professionals, and other key stakeholders to advance shared community health goals. As with any effort involving partnerships, coalitions, or other forms of collaboration, certain factors can serve as enablers, others as impediments. In the subsequent sections of this report we exam-ine the factors that are most relevant to collab-orative and integrated approaches to planning and public health in New Mexico. To put these factors in context, it is interesting to note that manyofthefindingsfromourownstatereflectthethemesidentifiedacrossthecountry.


Barriers to CollaBoratioN

In 2006, the American Planning Association (APA)releasedareportonToolsandStrategiesto Create Healthy Places, entitled “Integrating Planning and Public Health,” which included a survey sent to 3,320 members of APA and the National Association of County and City Health Officials(NACCHO)viaemail.Perhapsnotsurprisingly, the report highlights several practi-cal and substantive barriers planners and public healthofficialsfacewhenseekingtocollaboratewith one another. The biggest barrier reported by both professions was the lack of staff resourc-es to expand their agency’s mission to include planning or public health activities. Another bar-rier of note was accessing data from the other profession to incorporate into their own plans and activities.

In2009,theCDCfacilitatedaconveningof20expertsinthefieldofcommunitydesigntoex-plore similar questions, including how awareness of health can be incorporated in community design decisions. The report from this meet-ing highlights a key challenge of public health professionals not being involved in critical early stages of policy and project development at the local level. Additionally, the meeting brought to light a common concern about health, but a lacking common language among the disci-plines.

oPPortuNities For CollaBoratioN

The same two reports provide detailed rec-ommendations for addressing these barriers and enabling opportunities to collaborate more successfully across disciplines. A few key high-lights include:

• Address the common language challenge by clarifying terms in each profession and promoting more dialogue like the glossary of healthy community terminology devel-oped by the CDC: https://www.cdc.gov/healthyplaces/terminology.htm

• Identifyspecificmechanismsandwaysforpublichealthofficialstoengageinpolicyformation and planning processes. Involve them from the earliest stages, and keep them involved until changes are observ-able on the ground so as to enable the reflectionofmultipleperspectivesandin-corporate feedback. These stages include:

1. visioning and goal setting

2. plans and planning

3. implementation tools

4. site design and development

5. public facility siting and capital spending.

Key Terms HealtH equities or Disparities: “types of unfair health differences closely linked with social, economic or environmental disadvantages that adversely affect groups of people.” (CDC)

active transportation: “any self-propelled, human-powered mode of transportation, suchaswalkingorbicycling.”(CDC)

Additional resources can be accessed at: https://plan4healthnm.com/resources/

22


complete streets: Complete Streets are streets for everyone. They are designed and operated to enable safe access for all users, including pedestrians, bicyclists, motorists and transit riders of all ages and abilities. (SmartGrowthAmerica)

HealtH: A state of complete physical, mental, and social being and not merely the absence ofdiseaseorinfirmity.—(WorldHealthOrganization)

social Determinants of HealtH: Conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources atglobal,nationalandlocallevels.—(WorldHealthOrganization)

equity vs. equality: : Equity,, involves trying to understand and give people what they need to enjoy full, healthy lives. Equality, in contrast, aims to ensure that everyone gets the same things in order to enjoy full, healthy lives. Like equity, equality aims to promote fairness and justice, but it can only work if ev-eryone starts from the same place and needs the same things.

integrative approacHes: Bringing together the complementary strengths of both profes-sions and incorporating diverse perspectives to undertake collective action.

HealtH impact assessments (Hias): A com-bination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. HIAs can be used to evaluate objectively the potential health effects of a project or policy before it is built or implemented. It can pro-vide recommendations to increase positive health outcomes and minimize adverse healthoutcomes.(CDC)

Context in New MexicoOverview

The challenges and opportunities related to community health and planning in New Mexi-co can be understood through the lens of the specificsocial,environmental,economic,andhistoriccontextsthatdefinetheregionalculture.

The long history of settler-colonialism pre-dat-ing United States annexation of the state has resulted in an extremely mixed and multi-cul-tural population, with nearly half of the popu-lation identifying as Hispanic/Latino, over 10% as Native American, and 38% as White alone, according to 2016 Census estimates. New Mex-ico’s migratory population comes largely from Mexico and Central America, and Albuquerque in particular has a large and diverse migrant and refugeepopulation.NewMexicoishometo19Native American pueblos, each a culturally dis-tinct sovereign nation, three Apache reservations (including the Fort Sill Apache Tribe, Jicarilla ApacheNation,andMescaleroApacheTribe),as well as large portion of Navajo Nation and several Navajo chapters. The state is likewise lin-guisticallydiverse,with47%identifyingasfluentSpanish-speakers by 2011 Census estimates. Ar-eas of New Mexico are home to unique dialects ofSpanish,reflectiveofthelong-termsettlementand relative isolation of certain rural communi-ties. There are eight Native American languages spoken across New Mexico (NM Secretary of State,2017).

While there have been improvements in cer-tain community health indicators in recent years,


New Mexico still struggles with issues related to health equity across the state. Some of the key outcomes and indicators that the New Mexico DepartmentofHealthOfficeofHealthEquitytracks and works to address include:

• Teen pregnancy rates, which continue to be higher among Hispanics and Latinos than for any other racial or ethnic group.

• Diabetes death rates and youth and adult obesity rates, which are highest among Native Americans. These rates are also high among Blacks/African Americans and His-panics.

• Tobacco use, which is substantially higher among those with low incomes.

• Infant mortality, which is highest among Blacks/African Americans.

• And more. Source: New Mexico Department of Health, Health Equity Report, 2016

Key Characteristics and Factors that Affect Community Health

populAtion distRiBution

More than half of the state’s population of 2 million is concentrated in the central metro regions,withanestimated1,171,991peopleresiding in the Albuquerque/Santa Fe/Las Vegas combined statistical area in 2016 (City Popula-tion,2016).

Much of the rest of the population is dispersed across the state in smaller rural communities. Global and national patterns toward urbaniza-tion are compounded in New Mexico by several factors. The largest cities in the state follow a north-south orientation along the Rio Grande riverandtributaries,reflectingahistoryofsettle-ment along existing water resources.

Patterns of highway development have greatly impacted population distribution as well. The advent of the interstate highway system shifted tourism away from small rural towns which had previously been economically reliant on Route 66traffic.

While transportation infrastructure plays a vital role in New Mexico’s economic well-being, transportation connectivity is a major challenge in general in a state with such a widely dispersed population(TRIPNewMexicoreport,2015).Inmany rural communities, access to health care, services, and other resources is severely limited for individuals without a car. Even within cities, effectivepublictransitislogisticallydifficulttoimplement with existing development and low-density land use patterns.

Housing equity is another major challenge to communities across the state, encompassing a range of issues which include substandard housinganddisplacementduetogentrification.The2017“PointInTime”countidentifiedtheminimum number of individuals experiencing homelessness on a single night across the state as 1,186, while the New Mexico Coalition to End Homelessness estimated in 2005 that 17,000 people experienced homelessness in the course ofayear(NMCEHPIT,2005,2017).

cultuRAl RelevAncy

NewMexico’smulticulturalheritagedefiesaone-size-fits-allapproachtoplanninganddevelopment. Such a heritage can serve as an asset when culturally-relevant approaches are employed, but it can also present a number of challenges. For instance, a pressing need for cultural relevancy in approaches to health and planning for indigenous communities often proves a barrier to effective and supportive col-laboration between tribal authorities and outside practitioners and agencies.

24


Structures for community organizing, resource allocation, and self-governance are necessarily complex due to the overlap and intersection of rights to land, water, or minerals as determined byhistoricprecedentorcurrentlegaldefinition.This gap is often compounded by bureaucratic and jurisdictional overlaps between tribal, state, and federal authorities which slows or stalls delivery of important services, interfering as well with the ability of communities on both sides to implement and maintain shared resources and infrastructure.

Other historically marginalized populations face similar challenges in language, communi-cation, and access to resources. Communities all over the state with many undocumented mem-bers often refrain from accessing services due to fear of deportation, and subsequently struggle with substandard housing, lack of clean water, and lack of health care. Colonias, unincorporat-ed settlements found largely in the south of the state, often lack any kind of basic infrastructure for water, waste management, or power.

While such characteristics can present chal-lenges to public health and planning efforts, strong cultural identities and community cohe-siveness can also present opportunities for agen-cies, organizations, and other groups to leverage culturally-relevant frameworks that may be more effective in improving community health than more generalized approaches.

enviRonment And industRy

New Mexico has long been home to a variety of extractive industries, including coal, oil, and uranium. These industries are central to the economy in many regions and can provide eco-nomicandcommunitybenefits,butalsohavea history of environmental contamination and negative human health impacts. The nuclear in-dustry is extremely prominent, including uranium extraction, development of nuclear technology,

Fig.4 Uranium mines in New Mexico

and byproduct storage and disposal. Proximi-ty to nuclear operations has deeply impacted many rural communities, especially indigenous communities in the northwest of the state, with a legacy of contaminated groundwater and soil and the long-term health effects of exposure to radioactivity (McKinley Community Place Mat-tersHealthImpactAssessment,2014).

Food And wAteR supply

Water resources are of central importance in an arid climate. Statewide, water sources vary, with many towns built near existing groundwater and receiving surface water seasonally with the snowmelt. In areas such as Albuquerque, where population growth has surpassed existing water resources, the San Juan-Chama project diverts three tributaries of the Colorado river into New Mexico to supply public water (Colorado River WaterUsersAssociation).


Lack of access to clean drinking water is a critical issue in rural areas, particularly for much of the treaty land allocated to tribes around the state, either because water resources are con-taminated or because they do not exist (EPA, 2016).Non-tribalruralpopulationslikewisestruggle with environmental contamination of groundwater due to extractive industries.

Water management and irrigation for some agricultural communities still relies on the ace-quia systems put in place during Spanish settle-ment, and which recall early Puebloan irrigation strategies. The acequias demonstrate a tradition of shared and communally maintained water commons which continue to be an important piece of agricultural infrastructure and regional heritage for communities, as well as a model for cooperative community planning (NewMexico-History.org).

Access to healthy food is a challenge in a climate that is not always conducive to food produc-tion, and in a state with a widely dispersed rural population.

suBstAnce use/ ABuse

This is a major issue throughout the state, tied to socioeconomic factors, lack of adequate addiction treatment and mental health care, a high prevalence of alcohol outlets and drug availability. Proximity to historically established internationaltraffickingroutes(“heroinhigh-way”)isacontributingfactortothenarcoticsepidemic throughout the state, while the prev-alence of methamphetamines continues to be a major challenge for many communities. A na-tionwide survey of high school students in 2016 found that New Mexico teens report some of the nation’s highest rates of drug use, and from 2006-2010, New Mexico ranked highest in the nation for deaths of individuals between ages 20-64 which were attributable to alcohol use, at 16.4% (CDC Youth Risk Behavior Survey, 2016; and CDC Contribution of Excessive Alcohol Consumption to Death and Years of Potential LifeLostintheUnitedStates,2014).

looking FoRwARd

New Mexico’s diverse population, history, and climatenecessitateacarefulandspecificap-proach to evaluating and improving community health statewide. For many communities, health disparities related to poverty, geographic isola-tion, and environmental contamination are part of a larger picture of historic trauma and social disenfranchisement tied to colonization and systemic racism. Issues related to equity, access, and health are tightly interconnected across disciplines here, highlighting the possibilities offered by collaborative and transdisciplinary approaches to community health.

26

gAllup, RuRAl/ semi uRBAn context

tAos, indigenous context

AlBuqueRque, uRBAn context

27

Methods & Results


Assessment Methods

The purpose of this section is to detail each step taken that ultimately informed the overall assessment report. Here, we present the bulk ofthefindingsfromthePlan4HealthNMassess-ment of the planning and public health land-scape in New Mexico. During the spring of 2017, we engaged key stakeholders from around the state to gather information, share lessons and resources, strengthen existing networks, enable new relationships, and identify future opportuni-ties and recommendations.

Key QuestionsIn gathering and analyzing information, we

sought to address the following questions:

1. What are the key issues across New Mex-ico related to planning and public health, and how do these relate to the health of our communities?

2. What are the key assets and resources that currently enable planners, public health professionals, and other stakeholders to collaborate on integrated approaches to community health?

3. What are the key challenges and barriers?

4. What are the best practices and potential models for integrating planning and public health and improving community health outcomes?

5. Looking ahead, what are the key opportu-nities for advancing the work of coalitions of planners and public health profession-als?

Information Gathering Methods

online suRvey

To gather baseline information about topics and issues related to health and planning in New Mexico, Plan4Health NM designed and launched an online survey via Survey Monkey. The survey consisted of 16 questions, designed to gather both quantitative and qualitative input from a broad range of professionals in planning, publichealth,andotherrelatedfieldswhoareinvolved in work to advance community health around the state. The survey was distributed to individuals across the state via several online listservs and individual outreach. This resulted in aconveniencesample,with89respondentsintotal.

AREA OF RESPONSIBILITY

PRIM. AREA OF RESPONSIBILITY

Planning 20

Design 1

Admin/Managment 21

Advocacy 4

Data Collection 1

Teaching 2

Policy 2

Other 18

Outreach 8

25.97%

1.30%

27.27%

5.19%

1.30%

2.60%

2.60%

23.38%

10.39%

Fig.5 Assessment results: Primary area of responsibility

28


H

EALTH

PLANNING

OTHER

SECTOR

WORK SECTOR

HEALTH 29 PLANNING 23 OTHER 25

37.66%29.87%32.47%

TYPE OF ORG.

GOV. 33 COMMUNITY-BASED 13PRIVATE 8 FOUNDATION 4 OTHER 17 UNIVERSITY 2

42.86%16.88% 10.39%5.19%22.08% 2.60%

WHERE DO YOU WORK ?

NORTH WEST 2NORTH EAST 17SOUTH WEST 3SOUTH EAST 20ABQ METRO 35

type of org

WHERE DO YOU WORK?

URBAN 33 42.86%RURAL 31 40.26%SUB-URBAN 6 7.79%TRIBAL 7 9.09%

The graphics illustrate the sectors, professional roles, locations, and other characteristics of the89surveyrespondents.Asisevident,someregions(particularlytheNorthwestandSouth-west)hadverylowresponsenumberstothesurvey.Toensureperspectivesfromthesepartsofthe state were represented in this assessment, the Plan4Health NM team relied on input from regional event participants to supplement survey responses. The organizations listed in the introduction indicate the organizations that were represented at regional events.

Fig.6 Assessment results: Work sector

Fig.7 Assessment results: Type of organization

Fig.8 Assessment results: Area where respondents work Fig.8 Assessment results: Environment where respondents work


RegionAl events

To glean more details about prevalent issues in different localities, and to ensure represen-tation of diverse perspectives from around the state, Plan4Health NM hosted four regional events during May and June, 2017. Each event involved 10-20 participants from local govern-mentagencies,non-profitorganizations,com-munitygroups,andotheraffiliations.Duringeach two-and-a-half-hour event, participants shared their perspectives on the most pressing healthy community design issues in their area, key assets/resources and challenges/barriers affecting their work, existing and aspiring net-works, and ideas for new collaborations and innovative solutions. The events included:

1. Northwest region: May 1 at the New Mexi-co Cancer Center in Gallup, co-hosted with McKinley Community Collaborative for Health Equity

2. Southwest region: May 11 in Las Cruces, at theofficeofco-hostDoñaAnaCommuni-ties United

3. Northeast region: May 12 at the Santa Fe Community Foundation, co-hosted with New Mexico Health Equity Partnership

4. Southeast region: June 22 at New Mexico State University in Carlsbad, co-hosted with United Way of Carlsbad

FinAl RoundtABle event

OnJuly18-19,Plan4HealthNMhosteditsfinalevent,aroundtable-styleeventwithap-proximately 50 attendees from the planning, publichealth,andotherfieldsfromacrossthestate. The event included a capacity building workshop focused on data and mapping ran by MNCDC, presentation of the assessment’s keyfindings,facilitateddiscussionandfeedbackon proposed recommendations, presentations of case studies and best practices included in the assessment, and networking. Input from the discussion was then incorporated into this report and ideas for building on the momentum gen-erated through this initiative in the future were discussed.

otheR meetings And inteRviews

To identify and understand existing networks, organizations, and initiatives, the Plan4Health NM team also participated in a number of group meetings and individual information gathering interviews and conversations. Early in the proj-ect, we attended meetings hosted by some or-ganizations listed in the introduction, to spread awareness of the initiative, identify key stake-holders in various regions, and prioritize contacts for follow up conversations. During the remain-ing months of the project, the Plan4Health NM team arranged individual and small group information-gathering meetings to identify case studies for inclusion in this report and under-standthecontexttoinformthekeyfindingsandrecommendations of this report.

BAckgRound ReseARch

The Plan4Health NM team also conducted online research, and accessed information and resources from the national Plan4Health cohort members, webinars, and other channels.

30


Assessment ResultsThe following results are drawn from all of the information gathering methods described above.

As mentioned previously, one of the key ideas championed by the Plan4Health NM initiative, and the national Planners4Health program, is to advance integrated and collaborative initiatives be-tween planners and public health professionals to improve community health in a holistic way. In the context of this report, integration means bringing together the complementary strengths of both professions and incorporating diverse perspectives to undertake collective action.

To develop a baseline understanding of the current level of integration between planning and public health professionals in New Mexico, we gathered the following information via the survey:

To what extent would you like topics of health and planning to be integrated in your work? (scaleof1-3.1=notatallintegrated,2=somewhatintegrated,3=extremelyintegrated)Average: Planning:2.82 Health:2.93 Other:2.7

To what extent WOULD YOU LIKE health and planning integrated in your work?

1: not at all integrated 2: somewhat integrated 3: extremely integrated

planning2.82

health2.93

other2.7

1 2 3

To what extent are health and planning integrated in your work?

1: not at all integrated 2: somewhat integrated 3: extremely integrated

planning2.43

health2.48

other2.54

1 2 3

To what extent are topics of health and planning already integrated in your work? (scale of 1-3.1=notatallintegrated,2=somewhatintegrated,3=extremelyintegrated)Average:Planning: 2.43 Health: 2.48 Other: 2.54

Planning2.43

Other2.54

Health2.48

Health2.93

Planning2.82

Other2.7

Fig.9Assessmentresults:ExistingintegrationofHealthandPlanning

Fig.10 Assessment results: Desired integration of Health and Planning


How are you measuring your success in

implementing health and planning initiatives?

27 50METHODSinclude

DIRECT FEEDBACK from community members and affected stakeholders

DATA FROM INTERMEDIARIES LIKE GRANTEE ORGANIZATIONS AND

GOVERNMENT AGENCIES

MEASURES include

WIDE RANGE OF HEALTH OUTCOMES

TRANSPORTATION RELATED INDICATORS LIKE USAGE OF TRAILS, ROADS AND SAFETY

INDICATORS

OUTPUTS SUCH AS POLICY ADOPTION,

PARTNERSHIPS FORMEDINITIATIVES FUNDED

INCORPORATION OF HEALTH DATA IN COMP. PLANS

INITIATIVES

POLICY

due to factors like lack of capacity and/or lack of

priority placed on measuring

NOT MEASURING MEASURING

Fig.11 Assessment results: Measuring success of integration

32


While these results do not indicate major differences between professions and between existing and aspirational states, we do see a slight gap between the desired degree of integration of topics of health and planning and the current state, among all respondents. Most respondents across health, planning, and oth-erfieldsexpressedaninterestinhavingthesethemes become “extremely integrated” in their work. Currently, respondents across all profes-sions tended to consider such topics to already be at least “somewhat integrated,” indicating that a strong foundation exists upon which to build to achieve stronger integration. With this baseline in mind, we examine what it would take to achieve these goals in the following sections.

#1 What are the key issues across New Mexico related to planning and public health, and how do these relate to the health of our communities?

As part of this assessment, the Plan4Health NM team created a storymap that shares data and success stories on four themes at the inter-section of health and planning of key relevance to New Mexico. These are themes that were identifiedthroughtheassessmentphaseoftheproject as important to planners, public health practitioners, and other stakeholders across the state. Throughout, the storymap shares success stories and highlights key divides – such as be-tween urban and rural areas – on some of these issues.

Fig # Lower life expectancy is associated in many cases with higher poverty areas. For ex-ample, in southern Bernalillo County, southern Roswell, and the western counties.

View the storymap :

https://plan4healthnm.com/four-themes-in-planning-health/

Fig. 12 Povery Index & Life Expectancy, Both Sexes, 2007-2011

Also, in an open-ended question in the survey, respondents were invited to articulate the top three issues related to healthy community de-sign in their area. To analyze and present these issues,categorieswereidentifiedandresponseswere coded and organized in these categories. This information was then grouped by region, and as some regions had low survey response rates, information from regional event discus-sions was incorporated into the following word clouds.

Fig. 13 Where Teens 10-17 Years Old Live


child care

economic develop-ment

homelessInfrastructure


ACcESS TO HEALTH CARE

TRAILS

socialjusticeLACK OFFUNDING

HEALTHFOOD ACCESS

SUB-STANCEABUSE

MENTAL HEALTH

S T R E S S

E N V I R O N M E N TA L J U S T I C E

ROADS

recreational facilitiesracism

gentrificationeconomicissues

POVERTY

community understanding

LEADERSHIP/ COMMITMENT

NEED TO COLLABORATE

chronic disease

holisticapproaches

safety

sociocultural fit

L O W D E N S I T Yp o l i c y

ageism

addiction

diFFeRences Between uRBAn, RuRAl, suBuRBAn, And tRiBAl AReAs:Whiletherewerenotsufficientresponsesfromrepresentativesfromeachcommunitytypetodraw clear conclusions about differences between each, anecdotally, we understand there is a persistent divide between the most pressing health and planning issues and related resources in urban, rural, suburban, traditional hispanic communities, Colonias and tribal communities. Additionally, such categorizations may be incomplete or troublesome ways to framesuchdifferences.Forinstance,urbanandruraldefinitionsarenotalwaysclearcutinIndigenous communities, as Pueblos have historically been more urban given their types of governance,buildings,andrelativedensity,eventhoughthismaynotfitwithWesternframe-works of urbanism.

Fig.14 Statewide planning & public health issues

34


poverty

housing & homelessnessNEED FOR COLLABORATION LEADERSHIPCOMMITMENT

COMMUNITY UNDERSTANDING

I nf

ra

st

ru

ct

ur

e de

sig

n th

at

aff

ects

ph

ysi

ca

l a

cti

vit

ysocial justice

RACISMeconomicissues

HEALTHY FOOD

ACCESS TO HEALTHCARE

s u b s t a n c e a b u s e

STRESS

ACCESS TO EARLY CHILDHOOD CAREENVIRONMENTAL JUSTICEGENERAL HOUSING DISCRIMINATION AGAINST PROTECTED CLASSES (HUD)

AGEISM

GEN

TRIF

ICA

TIO

NBE

HAVI

ORAL

HEA

LTH

RESO

URCE

EQU

ITY

Stakeholder quotes from Northwest region: • Sprawl and aging infrastructure

with the inability to fund improvements

• Diabetes alcohol and drug abuse

• Lack of access to health care in general in rural areas

• Lack of economic development

infrastructure & Design that affects physi-cal activity

substance abuse

LACK OF FUNDING or alignment with priorities

ACESS TO HEALTHCARE

NEED FOR HOLISTIC APPROACHES

Equity in investment

EARLY CHLDHOOD CARE

Homelessness

S T R E S S

Need for collaboration/leadership/commitment

MENTAL HEALTH

SOCIAL JUSTICE ISSUES

POLICY

SAFETY

Community understanding /education / inspirationStakeholder quotes from

Northeast region: • Segregation of community by

income and by race• Lack of good public transit• No walkability from low-

income neighborhoods to jobs

• Lack of knowledge regarding proper nutrition

• Lack of affordable housing.

Fig.15 Northwest NM planning & public health issues

Fig.16 Northeast NM planning & public health issues


CHRONIC DISEASE

diabetes

eco-nomic issues

POVERTY

ACCESS TOHEALTHCARE

PHYSICIAN shortage

SUBSTANCEABUSE

infrastructure & Design that affects physi-cal activity

Equity in investment

HEALTHY FOOD ACCESS

Community understanding /education / inspiration

Need for collaboration/leadership/commitment

EARLY CHLDHOOD CARE

LACK OF FUNDING

NEED FOR HOLISTIC APPROACHES

social issues gentrification , racism ageism

CRIME

STRESS

Stakeholder quotes from Southeast region: • Poverty• Lack of access to transportation; • drugs; • Access to mental health resources;

local access to quality health care and services

• We need healthier food options in town.

LACK OF FUNDING OR LACK OF ALIIGNMENT WITH PRIORITIESInfrastructure


recreational facilities

economicissuesHEALTHY FOOD

ACCESS TO HEALTHCARE

AFFORDABLE HOUSING

CHRONIC DISEASE

DIABETES

TRAILSROADS

REGEIONAL TRANSIT CONNEC-TIVITY

EDUCATION

BEHAVIORAL HEALTH CRISIS

DISPARITIES IN INSURANCE

STRESS

NEED FOR COLLABORATION LEADERSHIPCOMMITMENT

HOLISTIC APPROACHES

S O U T H W E S T I S S U E S

Stakeholder quotes / responses from Southwest region: • Lack of safe, integrated

active transportation options

• Short-sighted attitude that healthy communities cost more

• Funding• Agreement within

administration as to what is best for the constituents.

Fig.17 Southeast NM planning & public health issues

Fig.18 SouthwestNM planning & public health issues

36


INFRASTRUCTURE & design THAT AFFECTS PHYSICAL ACTIVITY

SAFETYECONOMIC ISSUES AND POVERTYHEALTHY FOOD ACCESSEQuity in investment &access

LACK OF FUNDINGor ALIGNMENT WITH PRIORITIES

ACCESS TO HEALTH CARE

community understanding/ education/ inspiration

ENVIRONMENTAL JUSTICE incl. WATER

SOCIO-CULTURAL FIT

COLLABORATION

cOmmitment

leadership

GENTRIFICATION

AGEISM

racism

social justice issues

LOW

POPULATIO

N

DENSITY

MENTAL HEALTH ISSUES

CHRONIC DISEASE

SUBSTANCE ABUSE

policy

Stakeholder quotes from Albuquer-que Metro region: • Unsafe & unwelcoming pedestrian

environments Low density single use residential development lack of access to healthy food

• safe places to be active communities built around cars design that promotes community violence

• Land use policy • Economic priorities • Political will• Equity • Access to quality health care for all • Mental/Behavioral health services

for all

#2: What are the key assets and resources that currently enable planners, public health profes-sionals, and other stakeholders to collaborate on integrated ap-proaches to community health?

PLACE HOLDER

Fig.19ABQMetroplanning&publichealthissues

In the online survey, respondents had the opportunitytoselectpredefinedfactors(includ-ing funding, policy, regulation, networks, data sets, organizational commitment, leadership, aspecificpartner,other)thatcurrentlyenablethe integration of planning and public health in their work. Each respondent could choose up to three factors, and the results are indicated in the bar graph below. Respondents also had the opportunity to elaborate on their responses, as captured in the following discussion section. Identifiedasthemostimportantenablerswereorganizational commitment, networks, leader-ship, and policy. While there were not enough responsestoidentifysignificantdifferencesbetween regions, a subsequent section identi-fieskeydistinctionsbyprofessiontype.Tobetterunderstand each of these factors and additional factors that were not included in the initial survey, why and how they serve as enablers, and any regional differences, we gathered more

ORGANIZATIONAL FUNDING

REGULATION

POLICY

NETWORKS

DATA SETS

LEADERSHIP

SPECIFIC PARTNER

OTHER


POLICY

NETWORKS

DATA SETS

LEADERSHIP

OTHER

FUNDING

SPECIFIC PARTNER

0 10 20 30 40 50 60

REGULATION

Fig 20. Statewide assets and resources


qualitative information. Based on discussions during regional events, individual interviews, and qualitative survey responses, the following factorswereidentifiedasthemostimportantassets and resources to advancing integrated approaches among planners, public health pro-fessionals, and other key stakeholders:

• Networks, Coalitions, Partners

• Individual Commitment

• Policies and Regulations

• Data


• Funding

• Communication

• Cultural Competency

veraging funding to enable the implementation of a project, which would not have been possi-ble without such relationships. Those working in small communities stressed the importance of these connections, especially building on those from within the community and providing crucial continuity of services and programs if funding is cut or limited. Networks and other groups alsoprovidestructureandspace(figurativelyorliterally)forexistingrelationshipstobestrength-ened and new relationships to be built; those in the Northeast and Southeast were particularly emphatic in appreciating the convening power of certain partners. By reinforcing such connec-tions,thedirectandindirectbenefitsgrowandexpand.

Unconventional or nontraditional partners (such as health and planning agencies partner-ingwithfaith-basedgroupsorartsorganizations)can push ideas to an even more creative and innovative level, and can enable the tapping of new networks, resources, and ideas. Further, re-lationships with individuals and organizations in different geographies and sectors serve as vital assets by offering opportunities for cross-sector learning, and accessing resources and knowl-edge one might not otherwise have access to. This can enable local actors to adapt best prac-tices to their own work, with an understanding of how results from other contexts might be repli-cated or differ locally. However, participants also shared that practices and models from outside of New Mexico are not always well-received. There is a sense, often grounded in past expe-rience,thatsuchexamplesaredifficulttoeffec-tively adapt and apply here due to New Mexico’s unique context. In terms of local assets, several event participants (particularly in the Southwest andSoutheast)citedtheimportanceoftappingacademic networks across the state (e.g. UNM, NMSU,ENMU,etc.)andleveragingresourcestherein such as students, datasets, mapping software, equipment, communications infrastruc-ture,andmore,tofillcapacitygapsinorgani-

netwoRks, coAlitions, pARtneRs

Whilerelationshipsbetweenspecificpartnersand among actors in coalitions and networks are far from perfect, these types of links were iden-tifiedbyalltypesofactorsineachregionascru-cial for advancing integrated community health work. A better understanding of which type of relationshipismostbeneficialindifferentsitu-ations (depending on the local context, goals, etc.)wouldbehelpfultoexplorefurther,butfornow, it is clear that such relationships offer many types of value.

In a broad sense, partners/collaborators/net-work members serve as allies and support each other by developing shared goals and com-mitments. It was mentioned that this can offer intangible support such as greater visibility and added credibility, and more concrete support such as funding, in-kind resources, technical assistance, and implementation. Several exam-pleswereprovided(seebelow)ofpartnersornetworkmembersfillinggapsincapabilitiesorle

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zations or networks.

Each Plan4Health NM regional event included a network mapping exercise. Participants shared lists of their strongest partners and the networks to which they felt most connected, both locally and in other parts of the state and country. Somespecificorganizationsandnetworksfeatured prominently on many lists, regardless of regions.

Fig. 21 Southwest Planning & Health networks

individuAl commitment

Distinct from the actors operating on the net-work level, the theme of individual commitment and relationships was a recurring thread in many of the responses regarding assets and resourc-es. Some went as far as to say that individuals, who may not hold formal roles, are sometimes morebeneficialtocommunityhealtheffortsthanofficialorganizations(especiallythosewithineffectivestructures,processes,priorities,etc.).Many professionals in this line of work seem to see themselves as a network of individuals, often relying on personal relationships to get things done, either unintentionally or deliberately by-passing institutional structures and processes.

While personal relationships can be powerful enablers to moving work forward, there are also a number of potential downsides to trying to address long-term, complex issues in this way (seeNetworkLimitations,below).Regardlessofthe challenges, the commitment of individuals is real; those that bring consistency and integrity to their work were highlighted as the greatest assets in this assessment. Additionally, an idea that was particularly prominent in the Northeast regional discussion was the importance of peo-ple who work with an abundance mindset (rather than scarcity mindset – see Lack of Leadership section,below).Althoughthereisasensethatthese individuals are relatively few and far be-tween, they have the potential to bring needed creative approaches to this challenging work, and to serve as leaders regardless of their formal role.

Anotherfindingrelatedtothethemeofindividual commitment is the importance of community leadership. In communities across the state, community members – especially those who generally engage consistently in specificplanningandhealthprocesses–havebeenidentifiedassomeofthemostimportantassets to collaborative approaches for advancing community health. This is due in part to funding limitations, as community members often en-gage as volunteers, but also because those who live day-to-day with the issues have some of the most valuable insights about the approaches that might work locally, and the ability to mobi-lize grassroots support and resources.

View the storymap : https://plan4healthnm.com/planning-health-network-in-nm/


have hosted local summits, one of which was focused on HiAP and how the concept can be best applied locally.

In terms of informing policy and regulation, grassroots engagement was consistently men-tioned as a positive driver. Particularly in the Southeast, grassroots efforts have led to positive influencesonorganizationalandotherpolicies.An example is the Tobacco Use Prevention and Control(TUPAC)program,astatewideprogramthat those in the Southeast have used as a plat-form for community engagement around tobac-co and other substance use/abuse. The TUPAC program has been an effective way to empower localgroupsandindividualstoinfluenceandshapepolicywhenbroader(statewideorfederal)policies are seen as not meeting local needs.

Another example, highlighted in the South-east with echoes in other regions, is the estab-lishment of local policies to address community health issues through a focus on children. Given the number of policies and agencies involved in kids’ – and by extension their families’ – lives, applying this lens has been a positive way to ad-dress community health and related issues in a more holistic way. Additionally, it was mentioned that school-wide programs to promote health and crime prevention (through after school activ-itiesandotherservices)havebeenmademoreeffective through policies that require more accountability for results than in the past.

Fig. 22 Statewide Planning & Health networks

policy And RegulAtion

Oneofthekeyfindingsfromtheregionalevent discussions was that policies and regu-lations,broadlydefined(includinglegislation,bylaws,organizationalpolicy,etc.),donotlimitcollaboration or integrated approaches to plan-ning and public health. In fact, there are several that serve as enablers. For instance, many peo-ple – and not just planners – cited the adoption of the Complete Streets approach and design guidance as a key positive development. The concept of Complete Streets has been adopted on many levels: as part of a Bernalillo County ordinance, as policy in Albuquerque, promoted bymetropolitanplanningorganizations(MPOs)across the state, and generally accepted as a policy by many other actors across the state.

Similarly,HealthInAllPolicies(HiAP),anoth-er national movement that has been adopted locally, was cited as a key asset. Many people – and not just from the public health sphere – mentioned HiAP as a useful framework to evaluate and set policies and ways of working for organizations, coalitions, and more far-reaching policies. Some communities, such as Las Cruces,

dAtA

Data sets, reports, platforms, and related trainingswereidentifiedaskeyassetsbyalltypes of stakeholders in all regions as part of this assessment. Beyond the importance of general availability of data and measurements related to planning and public health, stakeholders high-lighted t he usefulness of granulated data and data sets that are available on a neighborhood level.Manyofthespecificdatasetsandrelatedresources mentioned by stakeholders

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involved in this initiative are included on the Resources page of the Plan4Health New Mexico website (https://plan4healthnm.com/resources).

Additionally, being able to access data sets and visualizations from a sector other than your primary one (for example planners accessing publichealthdata),washighlightedasakeybridgebetweenthefieldsandanenablertocol-laboration. The ability to access and understand data typically used by a profession other than one’s own can improve one’s understanding of the other profession, enabling these profession-als to connect in ways they had not before. Also, in viewing different types of data sets all togeth-er, planners and public health professionals alike pointed to the ability to identify new correla-tions, understand issues in a more holistic way, and track trends in ways that weren’t possible before.Thishasobviousbenefitsforplanningand implementing initiatives.

Across all regions, stakeholders also point-edtothebenefitofdatainacquiringfunding(understanding the need better and creating a more compelling connection to program plan-ning),andtrackinginitiativesduringandafterimplementation. Gathering and using data in all of these ways can also be a way to educate, empower, and mobilize community members around locally-important issues.

One example from the Northwest region is the Navajo Medicine Man data project, which involves gathering data from sources not typical-ly included in data sets, documenting these data in a systematic way, and sharing them to increase awareness of local indicators and inspire action. Trainings, such as those provided by the New Mexico Community Data Collaborative (NMC-DC)werealsomentionedasvaluableassetstoenable the access and use of data for maximum impact.

The importance of data (sets, visualizations, andrelatedtrainings)tothemanyHealthImpactAssessments(HIAs)conductedaroundthestatewas also emphasized in multiple regional meet-ing discussions.

While many of the points above speak to the general takeaways that apply across all profes-sional types involved in this initiative, survey re-sults also point to some differences in the aware-ness and use of data by profession. Among planners, there seems to be general awareness that health data exists – some are accessing re-portsanddatasetsthattheyfindhelpful.Someof the key types of data/reports mentioned as useful by planners in health-related work include:

• New Mexico Department of Health data

• Local HIAs

• Census data

• Master plans in various NM communities

• Data sets collected to measure the perfor-mance of initiatives.

Among public health professionals, almost all referenced health-related data, reports, and guides as crucial to their work. The lack of planning-related data sets and resource mentionedmayreflectalackofawarenessofplanning resources available, or may indicate that some health professionals do not see non-health resources as relevant to their work. Public health professionals mentioned these specificresourcesasmostimportant: New Mexico health data sets such as those on NMCDC, SHARE, IBIS

• Data on local youth risk factors

• Other local data such as health surveys, HIAs

• National sources such as the CDC.


53YES

24NO

AWARE OF DATASETS HEALTH REPORTS & PLANNING RELATED DOCUMENTS

• On the other hand, others cited low-tech, face-to-face connections and commu-nity-building communications efforts as key, and more important resources than technology-enabled communications. As an example, some local communities host in-person summits on locally-relevant top-ics to provide space and structure for vari-ous stakeholders to connect and exchange information. (This issue was highlighted in theSouthwest.)

cultuRAl competency

Culturally-relevant models, approaches, and methods are not always the norm, but when they are used, they serve as valuable tools to advancing community health. An example that was most prominent in the Northwest regional meeting was the use of the Navajo cultural mod-el of integration, a holistic approach to medicine, community design, nutrition, etc. that is more appropriate than western models in Navajo communities.

Additionally, creating a culture of caring in programs has been effective in some instances. For example, in the Southeast, a concerted ef-fort to reimagine truancy intervention programs (which can relate to a number of community healthindicatorsandplanning-relatedissues)asinviting, positive, and educational has resulted in more people using such programs early on, to address issues before there becomes a need to take punitive actions.

Fig. 23 Awareness of data sets and related documents

Through the regional event discussions and the online survey results, additional factors emerged, to a lesser extent, as assets and re-sources for this type of work. These included:

• Funding

• Communication

• Cultural Competency

Funding

• Although funding was primarily cited as a limitation(seesectionbelow),localsourcesof funding (many listed on the website-https://plan4healthnm.com/)werecitedas crucial to moving work forward. Despite the serious lack of funding in rural com-munities, a bright spot was the increase in number of rural small business incubators and the availability of business develop-ment counselors. (This issue was highlight-edintheSoutheast)

communicAtion

• Social media and other online communica-tions platforms can serve as assets, espe-cially for grassroots organizations, as these methods require few resources and can mobilize many people quickly.

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#3: What are the key challenges and barriers?

lAnguAge And communicAtion methods

Out of all the challenges articulated by people who engaged in the Plan4Health New Mexico project, challenges related to language and communication – both across and within dif-ferent professional spheres and communities – stands out as perhaps the most important and acknowledged by all.

Much of the challenge of professionals coming together to address community health issues from an integrated approach stems from a lack of common language and/or lack of com-mon understanding of terms and concepts between different professions. For instance, many highlighted the reliance on acronyms and jargon, the use of different and not clearly definedtermstoexplainconcepts,andthedifficultyofcommunicatingthemoretechnicalaspects of planning or public health to some-one from a different background as key bar-riers. Furthermore, many terms carry different nuances, associations, and even stigmas that may be different or not understood by profes-sionals in different sectors. By using such terms out of context or in a new context, a profes-sional in one sector may unwittingly make it harder to work across disciplines.


FUNDING

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Which of the following are currently lacking but would help you to integrate health and planning in your work?

DISCUSSION: GAPS & CHALLENGES 1) How are these limiting?

2) How would they be enablers?

3) Which are most important to prioritize moving forward?


STATEWIDE

Fig. 24 Statewide barriers and challenges

Information regarding key challenges and barriers was gathered in the same manner as described above for assets and resources. In the survey, when asked what was currently lacking but would help enable integrated approaches between planning and public health, respon-dentsoverwhelminglyidentifiedfundingasmostimportant. The factors of organizational commit-ment, policy, and regulation were the next most popular responses.

Further information gathering via regional events and discussions yielded the following factors as the greatest challenges and barriers to successfully integrating planning and pub-lic health approaches to advance community health:

• Language and Communication Methods

• Lack of Leadership and Organizational Commitment

• Funding and Capacity Limitations

• Network Shortcomings


• Community Engagement Methods

• Policy and Regulation


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ECONOMIC DEVELOPMENT AND EDUCATION

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Framing and tone were also brought up as challenges: different ways to frame the same issue, or the use of “touchy-feely” vs. “rational” tones can present barriers to effectively commu-nicating across professions. Further, even when communication between those in planning and publichealthisworking,communicatingspecificopportunities for improving healthy community design – beyond, for instance, promoting the idea of Health In All Policies – to a more diverse set of stakeholders (such as those in the private sector,othergovernmentagencies,andmore)canbedifficult.Regardlessofprofessionalrole,communicating concepts related to planning and public health in culturally appropriate and relevant ways can be a challenge.

For instance, the ways in which some Native communities understand and talk about health and wellness differ greatly from the non-indige-nous framings that often drive the conversation. Additional challenges to successful health and planning approaches relate to more universal organizational and structural communications issues. On an organizational level, many partici-pants pointed to silos that prevent transparency, clarity, and sharing of information, both within and between organizations.

Fig. 25 How healthy community design is views across professions.

For example, some regional event participants mentioned not being able to access information about their own organizations’ priorities related to healthy community design. Needless to say, they do not feel empowered to communicate those priorities to potential collaborators.

In addition to a lack of information, partici-pants were frustrated with the lack of forums (virtualand/orin-person)toregularlymeet,build relationships, share ideas, and learn from colleagues and new potential partners beyond their immediate, day-to-day networks. In the Southeast, professionals recognize that many communities face similar issues, but there is a lack of information sharing – and in particular sharing information about common strengths upon which to build. What is more, in some parts of the state, cell phone service and Internet connectivity is very poor and distances are far, so basic communication is a challenge. While the lack of Internet encourages positive face-to-face interaction, it hinders connectivity beyond imme-diate networks and slows relevant and timely communications.

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lAck oF leAdeRship And oRgAnizAtionAl commitment:

In the Plan4Health NM online survey and regional meeting discussions, the concepts of leadership and organizational commitment were often highlighted as interrelated barriers. Leadership–ofelectedofficialsandfromotherindividuals,regardlessoftheirofficialrole–was continually mentioned as a missing factor that would have the potential to translate into positive change and increased organizational commitment to integrated health and planning approaches.

A key challenge relates to the attitudes and mindsets of people who are already recognized as leaders or those who could be leaders. For instance, there are challenges that arise when individuals and organizations operate under a scarcity, rather than abundance, mindset. This was an important thread of conversation in mul-tiple regional events, especially in the Northeast. This is an understandable mindset given the real resource challenges across the state, but such an attitude can hinder creativity, innovation, and risk-taking associated with successful leadership. What is more, a scarcity mindset can reinforce strict hierarchical roles and siloed structures, as individuals’ purviews become more narrowly definedtoreflectlimitedresourcesandcapacity.Such structures can inhibit individuals outside of top levels from acting as leaders in their own right, empowered to make positive changes. Be-yond this scarcity mindset, but perhaps related, is the tendency to respond reactively rather than to proactively lead. In multiple regional meet-ings, participants alluded to a recognition that certainpracticesorchangescouldbebeneficial,but this is limited by an unwillingness to pursue them in the absence of a clear mandate, as reflectedinthesentiment:“Iwon’tdothatuntilpolicy or regulation requires it.”

Further, there is a sentiment, particularly in the

Southeast and Southwest, that strategies such as health promotion could be leveraged in many more ways than they currently are, but there is a lack of necessary support from the top to ex-pand the purview.

A related challenge, especially as highlighted in the Northwest, is the parochial attitude that can arise in an environment of scarcity. Partici-pants mentioned individuals, particularly local leaders, acting in self-protecting and territorial ways. This is an especially harmful barrier when local leaders act as gatekeepers to resources and networks in ways that are personally or polit-ically motivated. Additional challenges related to electedofficialsandpolicymakersonbothlocaland statewide levels arose in all of the region-al events. Beyond the gatekeeping problem, many stakeholders cited a troublesome discon-nect between these leaders and communities, in terms of engaging in productive dialogue, establishing a shared understanding of the local needs and priorities, and ensuring resource al-location is aligned and appropriate for the local context.

Further, in some communities (for instance in theSoutheastandSouthwestregions),thereisthe strong sense of disconnect between federal or other broad standards related to integrating planning and public health approaches and local priorities and initiatives. These two regions also cited a major challenge with turnover of officialsinleadershippositionsinstateentities.These entities, and relationships with individuals therein, are crucial, particularly for more remote communities. Attrition and turnover of liaisons at the state level diminishes any progress made in creating a mutual understanding of local needs and other mechanisms to serve local commu-nities. Among some, there is a frustrated and resigned sense that local professionals are con-stantly starting back at square one in terms of building productive relationships with individuals and entities across the state.


Funding And cApAcity limitAtions:

The lack of funding and nature of available funding – and related effects on capacity – are also key barriers to pursuing integrated health and planning approaches to improve communi-ty health. While this was highlighted consistently across all regions in the survey and in event discussions, distinct challenges were associat-ed with different areas, especially differences in urban vs. rural and, to some extent, north vs. south.

Perhaps the most straightforward and under-stood barrier is overall lack of funding across the state. This is not a challenge that is limited only to the realms of planning or public health, and there was general consensus that funding limitations across many sectors contributed to interrelated challenges and poor commu-nity health outcomes. For instance, economic distress in the state has led to funding cuts for anything not serving basic needs. Given the difficultyincommunicatingthebenefitsofcol-laborative planning and public health initiatives or coalitions, and the lack of evidence/outcomes tracked as described previously, such work is not likely to be considered a funding priority in such a resource-constrained environment. Even ifthebenefitsofintegratedplanningandpublichealth approaches are not consistently under-stood or articulated, various stakeholders cited a demand/need for this work that greatly outstrips capacity.

There are a number of ways that lack of fund-ing or lack of capacity to access funding leads to challenging capacity limitations. On a basic level, organizations and agencies are not able to hire an adequate number of professionals to support their mission, enable the continuous develop-ment of staff to achieve new goals, and commit other resources to implement plans and projects – these issues came through especially strong in

the Southwest and Northeast. Furthermore, integrated approaches to planning and public health are in some cases new and emerging, experimental, and in need of customization to the local context. This necessitates additional capacity building and training, and therefore additional(currentlyunavailable)resources,toachieve improved community health goals.

Related capacity challenges that seem particu-larly acute in the Southeast relate to a transient workforce and lack of local organizational capac-ity. Especially in this region, much of the work-force (overall and those providing direct services inhealth)comesfromoutofstate,andthereisa high migration rate in and out of the region. There is a need to build local capacity and a stronger workforce to avoid the need to start from scratch when people leave.

The nature and focus of funding strategies is as big of a barrier as the overall amount of available funding. Almost all stakeholders engaged in Plan4Health NM highlighted challenges associ-ated with grants, often the main funding mecha-nism for this type of work. These include:

• Effort-intensive processes involved in re-questing funding which can prevent orga-nizations from carrying out other work or preclude some from even applying due to limited capacity

• Imbalanced power dynamics between funders and grantees which can shut down open, two-way dialogue.

• Prescriptive guidelines and narrow priorities that can lead to a disconnect between fund-ed work and local priorities.

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Morespecifictoplanningandpublichealth,many stakeholders discussed funding needs related to strengthening networks, building coalitions, supporting core operations, and initi-ating local pilot projects – which are not always aligned with the intended purpose of available funding.

Additionally, many working and/or living in Na-tive communities cite a lack of funders acknowl-edging indigenous frameworks as legitimate, so work that is aligned with indigenous frame-works for health, wellbeing, and community are dismissed and not funded. What is more, there were other examples (especially in the South-east)offundingprioritiesshiftingwhensome–but perhaps not enough – progress is made on an issue, thereby limiting capacity for sustained positive change as resources are constantly reallocated in different areas. Taken together, allofthesechallengesresultinsomespecificprograms receiving adequate funding, but many gaps in services that planners and public health professionalsbelievewouldbebeneficialforcommunity health.

netwoRk shoRtcomings

New Mexico enjoys many well functioning net-worksthatprovidebenefitsincludingintegratedapproaches to improve community health. How-ever,stakeholdersidentifiedanumberofnet-worklimitationsasasignificantbarrier,including;

• Gaps within the composition of the network;

• Scope and reach of the network; and

• Organizational dynamics punctuated by lack of leadership or action.

Regarding the composition of health and plan-ning networks, a common theme from regional meeting discussions was the challenge of the usual suspects. It seems to be hard to expand networks beyond people and organizations

that are typically at the table. This presents problems because there will inevitably be gaps in the perspectives represented and capabilities that can be brought to bear on an issue. Also, management of and even basic engagement in networks takes consistent input of time and effort, which can become a burden rather than an enabler when the same small group of stake-holders is engaged in multiple networks. Ulti-mately, this can lead to burnout and disengage-ment of champions, and therefore unrealized potential or dispersal of such networks.

Some challenges relate to the scope of net-works, particularly for those not centered around the metro areas of Albuquerque and Santa Fe. For instance, some regions such as the North-west, Southwest, and Southeast have strong local networks, but are relatively isolated and dis-connectedfrombroader(statewideornational)networks. Some respondents cited challenges in even identifying the right agencies or individuals with whom to connect to address their needs. In some cases, there are practical challenges for more remote communities to connect with non-local networks (such as communications infrastructure, time to travel or identify the cor-rectcontact),butothersexpressedasensethatthose more plugged in to statewide or national networks intentionally disregard those who are in more rural areas. In these contexts, many local professionals and community members lack context to understand the larger networks in which they could operate, which becomes a problem in identifying and connecting with resources.

View the storymap : https://plan4healthnm.com/planning-health-network-in-nm/


Some of the network limitations that are likely mostdifficulttoaddressarethoserelatedtonetwork dynamics. For instance, some dynamics relate to inaction within networks. Several stake-holders, particularly in the Northeast, mentioned that people in health and planning networks are open to the idea of collaboration and often propose new ideas, but there is a real lack of action. This could be explained at least in part by the challenge of follow through given limited capacity and restrictive views of what is within one’s purview, as explained above.

Another challenging dynamic that can paralyze action within networks is misalignment of prior-ities and capabilities of actors within a network, which was mentioned in all regions.

When gaps exist in services, particularly when funding is abruptly cut, complementary capa-bilities do not exist in networks to be tapped to fillsuchgaps.Againperhapsrelatedtolimitedfunding and capacity, stakeholders bemoaned the emergence of competitive attitudes, rather than cooperative agreements, within networks related to health and planning. A challenge that seems particularly acute in the Northwest region is certain stakeholders feeling disenfranchised within their own networks.

There is a sense that organizations and agen-cies operating on a national level concentrate network power and resources at the national level, restricting local actors, and leading to a breakdown of trust and empowerment through-out the network.

Through the regional event discussions and the online survey results, additional factors emerged as challenges and barriers to this type of work. These included:

community engAgement methods

• Key voices and perspectives are not heard, or are even de-legitimized in planning and public health work (for instance Indigenous perspectives, people without certain aca-demic credentials, non-English speakers, etc.)(ThisissuewasdiscussedintheSouth-westandNorthwest.)

• In planning and public health, we often rely on methods of community engagement that are ineffective in that they do not ac-count for changing demographics, com-munications methods, and more. (This issuewashighlightedintheSouthwest.)

• This leads to the priorities of community membersnotbeingreflectedinplansandpolicies

• It is important to have community mem-bers at the table because they provide valuable information that may not be doc-umented or available anywhere else, and yet we often lack the capacity to engage more community members and build their capacity as leaders.

policy And RegulAtion

• Regarding policies that relate to both plan-ning and public health, a challenge high-lighted was that city and county bodies are quick to adopt policies, but do not track theirefficacyovertimetounderstandrelat-ed successes or unintended consequenc-es. As a result, an effective feedback loop does not exist and policies do not adapt in response to outcomes or changing needs.

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• There was a sense among some plan-ners that regulations involved in planning processes can limit creativity, sharing of resources, and innovation. (This issue was highlightedintheNortheast)

• Although case-by-case and organiza-tion-by-organization examples of success exist in integrating health and planning, there is a sense that policy is needed (andcurrentlylacking)toenablesystemicchange and leadership to improve com-munity health.

• The problem of policy being in place but not enforced. (This issue was brought up in theNorthwest)

• Some policies are punitive rather than ed-ucational or supportive. As a result, profes-sionalsincommunitiesseeafearofofficialsand authority by people in need, and therefore they do not engage with services inintendedorbeneficialways.(ThiswashighlightedintheSoutheast)

• Some working on the local level also cited a lack of understanding of how to imple-ment new legislation, as communication is lacking between statewide/federal and localofficials.

Differences by ProfessionAmongallofthefindingshighlightedabove

related to key healthy community design is-sues, assets/resources and barriers/challenges, respondents and participants from different professions and sectors tended to agree on the key themes that present opportunities or chal-lenges to integrated approaches to improving community health. However, there were some differences in the themes that professionals in thedifferentfieldstendedtoemphasizeintheirresponses, which could help to further illuminate the nuances in this work and identify ways to bridge any continuing gaps to collaboration.

plAnneRs

Overall, planners tended to highlight:

The importance of political will and collabo-ration between agencies and actors to enable planning, and the importance of funding to actu-ally implement plans.

The need to increase awareness of the impor-tance of integrating health in planning due to limited resources and the need to make tough choices. Related is the challenge of planners not working on health-related topics because it’s considered beyond their purview.

The need for sharing data across agencies and sectors, especially access to health data for those who do not work in health agencies.

The disconnect between federal/broad stan-dards for integrating planning and health with local priorities/initiatives. Local political leader-ship could be an effective bridge.

The recognition of positive, incremental change. For instance, recent comprehensive plans in different areas include guiding principles and goals related to community health.


Communities where people can safely and comfortably access work, recreation, healthy food, education, and services.The conscious development of infrastructure, policy and programs that promote active living, multi-modal choices and health equity in investmentsHealthy community design provides residents with access to safe, active transportation options, access to necessary services (medical, healthy food, education), and clean air and water.

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Fig. 26 How planners view healthy community design

puBlic heAlth pRoFessionAls

Overall, public health professionals tended to highlight:

• The importance of and success of existing strong networks within a particular region and/or community.

• The need for better education and en-gagement of public health professionals and community members, particularly in understanding and participating in plan-ning processes. Related, there is interest, by health professionals, in being included in community planning committees.

• The importance of school-based health services for kids and families.

• The disconnect between the general support for healthy community goals by policymakersandgovernmentalofficialsand the actual policies, which may not reflectrealcommunityneeds.

• Challengeswithfunding:specificprogramsare well-funded, but a lot of gaps in fund-ing exist for other services that would be beneficial.Forinstance,stateeconomicdistress leads to cuts in funding for any-thing not serving basic needs.

• Expresseddesireforspecificpartnershipsto be formed between health care service providers and those in planning communi-ty.

Healthy community design incorporates social determinants of health factors into the planning and design of a community.A healthy community design is developing a plan that takes a holistic approach to health and is equitable and inclusive of all people in every age and stage of their lives to promote a happy and healthy lifestyle.Design ideas come from community members who will most directly be impacted by them

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HP comm.designHealthy community design incorporates social determinants of health factors into the planning and design of a community.A healthy community design is developing a plan that takes a holistic approach to health and is equitable and inclusive of all people in every age and stage of their lives to promote a happy and healthy lifestyle.Design ideas come from community members who will most directly be impacted by them

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ACTIVE TRANSPORTATION OPTIONS AND ACTIVE LIVING 4

0SAFETY

HP comm.designFig. 27 How health professionals view healthy community design

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Aspartoftheassessmentprocess,thePlan4HealthNMteamidentifiedexamplesoforganizations,initiatives,andprojectsacrossNewMexicothatareaddressingbarriersidentifiedin the assessment. We present these examples in the following case studies, which demonstrate key goals, best practices, challenges, and lessons learned related to collaborative approaches to improving community health.

Thefollowingpagescontaincondensedinformationaboutthe9organizationsfeatured:

Case Studies

Overview

Preconditions to achieve

goals

Barrier(s)adressedfrom this assessment

Community design issues

addressed

Geographic Scope

Goals & Activities

Target Audience

Partnerships Challenges/ Gaps

Implications /Lessons Learned

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VIVA CONNECTSCase Study :

Village Interventions and VenuesforActivity(VIVA)Connects is a program devel-oped by the UNM Prevention ResearchCenter(PRC)andfunded by the CDC. It began as a community-academic partnership (VIVA-Step Into Cuba)betweenthesmallruralvillage of Cuba, NM, and the UNM PRC. Cuba residents ap-proached the PRC requesting assistance to identify, imple-ment, and evaluate strategies to get people moving.

Cuba became the beta site and core research project for the UNM PRC. Step Into Cuba applied a number of evidence-based practices that came from recommendations from US Department of Health and Human Services Guide to Community Preventative Services. These include:

• Community-wide cam-paigns

• Improving or enhancing access to places for physi-cal activity

• Individually adapted health programs

• Street Scale Design• Social support at the com-

munity level

Based on these practices, the projectfocusedforthefirst5 years on increasing access to places to walk through the development and enhancement of walking trails and sidewalks, improvement of the local park, and social support for physical activity through community walks and a community-wide campaign. Building on the suc-cesses of VIVA-Step Into Cuba, and guided by the lessons learned (information available https://www.stepintocuba.org/),the UNM PRC is creating a network of Action Communities across New Mexico.

VIVA Connects aims to engage communities in New Mexico with populations between 500 and 12,000 people, of which there are 163 across the state. As of spring 2017, 26 commu-nities had joined as “collabora-tive network members,” with a smaller subset engaged as “ac-tion communities” (committed to following evidence-based approaches and sharing infor-mation).

Network shortcomings; funding and capacity limitations

Joint community-academic initiative, bridging research and

implementation.

WHAT?

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• Understand how to best put research into practice to increase physical activity in rural,under-resourced set-tings.

• Develop a partnership between academia and communities by providing technical assistance and enabling the practical imple-mentation of research rec-ommendations.

• Create a vehicle to connect communities with similar characteristics and goals, and enable them to share knowledge and other re-sources.

• VIVA Connects includes in-person contact and a web-based platform that serves as an engagement and communication portal for promoting active com munities.

• Successful beta in Cuba, NM to serve as proof of concept and inspiration

• Substantial resources (con-sistent funding and staff capacity).

• Lessons learned from Cuba, and other knowledge and best practices in shareable form.

• Interest and engagement from additional communities to build robust network.

• Evidence-based recommen-dations

• Engaged community• Having a community cham-

pion

The partnership mix is different in each community: for example in Cuba, the Alliance includes the Village of Cuba, the local schooldistrict,localnon-profitorganizations, the local clinic, Sandoval County, New Mexico Department of Transportation, Santa Fe National Forest, Bu-reau of Land Management, and Continental Divide Trail Coalition. In order to achieve its goals, the Alliance holds reg-ular quarterly meetings, which guests are also invited to join.

VIVA Connects takes a de-mand-driven approach, re-sponding to interest from stake-holders in communities rather than proactively recruiting new communities to the network.

Tested with a single rural com-munity(Cuba,NM),andex-panding to rural communities state-wide

Built environment and social support to promote physical activity. Expanding to include resources for healthy eating and food access, and other resourc-es to improve health and quality of life.

It provides current evidence-based recommendations, user-tested prevention strategies, best practices and lessons learned, “ask the expert” facilitation, training modules, and webinars. As of spring 2017, VIVA Connects is curating and disseminating existing resources from multiple sources. In the future, VIVA Connects will produce and disseminate new, customized content in response to community demand.

VIVA Connects members include individuals, partnering agencies, community groups,and coallitions

As this work is still in the im-plementation phase (as of July 2017),initialchallengesandgapshavebeenidentified,butfurther analysis will be present-ed after program evaluation. Initial challenges and gaps include:

• As VIVA Connects works with different communities across the state, navigating differ-ent jurisdictions and related requirements and stakehold-ers can be challenging.

• Communities that VIVA Connects works with are not mutually exclusive: some groups who are part of the network operate on a county level, others on a town or neighborhood level (perhaps within the same area as a group operating on a county level),andothervariations.The way VIVA Connects communicates about and with stakeholders in commu-nitiesneedstoreflectthisvariation while remaining clear.

• Resources are spread ex-tremely thin – this goes for VIVA, the communities that we work with, and many of the agencies that these communities rely on for both financialandtechnicalassis-tance.

• New Mexico is a large state and the communities that we work with are scattered throughout it, so that means a lot of time on the road.

Sally Davis, Director, UNM Prevention Research Center and Professor, Department of Pediatrics ([email protected])Jeff DeBellis, Associate Scientist II, UNM Prevention Research Center, VIVA II team ([email protected])https://viva-connects.org

• Articulating lessons learned as a series of clear and manage-able steps helps empower and inspire communities to under-take similar efforts in their own contexts

• Connecting recommendations to evidence-based practices lends credibility

• Patience and celebrating small successes along the way helps keep stakeholders motivated to achieve longer term goals

• Having access to places to be active is a determinant in pro-moting physical activity in rural communities.

• importance of demonstrating success with community-based initiative, particularly in a community facing many challenges.

• Articulating lessons learned as a series of clear and manage-able steps helps empower and inspire communities to under-take similar efforts in their own contexts

• Connecting recommendations to evidence-based practices lends credibility

• Patience and celebrating small successes along the way helps keep stakeholders motivated to achieve longer term goals.

• Communities interested in undertaking similar efforts have many practical questions to implement their ideas (e.g. what are design requirements for trail signs, where can I get money topublishawalkingguide),anddonotalwaysknowwhattoask to be successful (e.g. which local entity can we use/do we need to create to receive funding; who from the planning sec-torcanIengage,andwhatvaluecantheyadd).

“If they can do it in Cuba, we can do it anywhere”

• Importance of demonstrat-ing success with communi-ty-based initiative, particu-larly in a community facing many challenges.

There are two requirements to be an Action Community:

1.TheVIVAConnectsteamfills2 or more requests for Techni-cal Assistance.

2.The VIVA Connects team does an intake interview where we interview one or more of their community champions.

Beta Site for VIVA IIVIVA Connects Action Communities

VIVA Connects Network CommunitiesVIVAConnectsNetworkCommunities(Tribal)

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Indigenous Design and Planning InstitutEiD+Pi

Indigenous Design + Plan-ningInstitute(iD+Pi)isaprogram of the University of New Mexico School of Archi-tecture+Planning(SA+P),established in 2011 to pro-vide a context for culturally relevant design and planning practices. Their work is based in applying indigenous frame-works to holistic community design, planning, and land tenure, and developing a contemporary understanding of indigenous design through both community-engaged and academic practice.

Traditional and contemporary indigenous design practic-es provide an effective and compelling model for inte-grated health and planning processes, addressing diverse determinants including food networks, community con-nectivity, open space, water resources, and cultural her-itage and education. iD+Pi works with what they call the “7 Generations Model,” which roots planning within respec-tive indigenous worldviews with a strong emphasis on stewardship of the land, the

people, and culture for future generations.

The community engagement approach of iD+Pi espouses three major tenets: • “No translators”–Individuals

have the relevant knowledge and experience to speak for themselves and their com-munities without re-interpre-tation.

• “They’re not minorities”–Challenge Euro-centric no-tions of demographics and marginality; center native communities as being repre-sentative of the place where they are from.

• “Native self”–Center in-digenous histories and knowledge in opposition to ‘cultural amnesia’; challenge Euro-Western concept of “objectivity” as mark of au-thority; personal relationship to history of communities is key to how community mem-bers approach communica-tion and planning.

This case study will examine iD+Pi’s approach through two completed community visioning and planning projects, the Zuni

zuni pueBlo mAinstReet pRoject

Zuni Pueblo became part of the NM MainStreet Program in 2012,thefirsttribeinthenationto hold a MainStreet designa-tion, and iD+Pi was subsequent-ly subcontracted for a visioning, engagement, and design pro-cess which would articulate the regional and cultural character of Zuni Pueblo while identifying goals and opportunities for the community. Activities includ-ed proposals for preservation and adaptive re-use of existing sites, plans for developing and increasing connectivity, and for generating design projects for thedistrictwhichreflectthespecificitiesofhistory,culture,and place for Zuni Pueblo. The activities were brought into a studio course which was offered through UNM SA+P, and which has since grown into an archi-tecture research studio.

at the university of new mexico

Case Study :

Pueblo MainStreet Project, and the Nambe Pueblo His-toric Plaza Revitalization Plan.

outcomes:• Presentation of project to

Zuni MainStreet Board, to the Tribal Council, and to the community at large in late 2013.

• Presentation of project to the American Planning Asso-ciation National Conference.

• Zuni MainStreet was award-eda$225,00grantbyArt-Place America in 2015 to continue the integration of arts and culture into rural creative placemaking along a segment of Highway 53.

A particular strength of the approach taken through the Zuni MainStreet project was an understanding of the role arts and culture play in community development and rural creative placemaking. Michaela Shirley, program specialist, noted that from an indigenous perspective, “Artists are more than vendors, they are historians, changemak-ers, creative problem-solvers, scientists,” whose work often reflectsaspecificrelationshiptoenvironment, climate, culture, and social connection which provides a valuable comple-ment to the perspective of administrators.

nAmBe pueBlo histoRic plAzA RevitAlizAtion plAn

Nambe Pueblo approached iD+Pi in 2013 about developing a Plaza Revitalization plan which could address historic preservation of the village plaza in light of the development sprawl and general deterioration of buildings which the historic plaza had been expe-riencing.

The project took on the form of a summer seminar held in col-laboration with Community and Regional Planning, in which two student interns from the tribe were hired by the Pueblo to assist. A summer studio was also held, which focused on community en-gagement to develop a historic preservation plan, as well as assess environmental conditions, produce photos and maps, and offer training in GIS and AutoCad.

Ultimately, with time and support from the Tribal Council, res-toration work was completed with the Pueblo’s historic Kiva for thefirsttimein500years.Therestorationplanalsoincorporatedopportunitiestorevitalizefarmingthroughcommunityfieldsanda traditional seeds project, and addressed how shifts in land use such as water management or monocropping had impacted the larger community. The project of revitalizing traditional agricul-tural practices is intricately linked to culture and ecology through land use, diet and nutrition, food preservation, and the transfer of language.

Excerpt of Nambe Pueblo Report by iD+Pi.

Excerpt of Zuni Pueblo Report by iD+Pi.

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Introducing traditional indigenous frameworks into community plan-ning, community-initiated visioning

processes, educational mission which encompasses community members and academics, policymakers, and profes-

sional practitioners alike.

WHAT?

Language and communication (includes culturally relevant approaches to community en-gagement and planning; educa-tion and training around devel-oping “indigenous planning” as anoutreachmodel)

Tribal and pueblo populations around the Southwest, as well as international indigenous communities.

Food networks and access to healthy food, water security and availability, open spaces/walk-ability/bikeability, cultural inher-itance, language preservation, community connectivity.

Most planning projects take place within New Mexico and Arizona, although the program has connections internationally, including Mexico, South Ameri-ca, Canada and New Zealand.

Tested with a single rural com-munity(Cuba,NM),andex-panding to rural communities state-wide

Community visioning process as a springboard for addressing community health.

Building community Resiliency.

• Language retention as a community health indicator: represents connections to land, ceremony, concepts, and worldview.

• Resiliency is built through strong community relation-ships and social cohesion.

• Community visioning pro-cess connects with revival and practice of traditional diets, farming techniques, language, family and com-munity structures.

• Develop avenues for com-munity self-determination in line with principles of indige-nous sovereignty.

• Reliance on community ini-tiative, and engaging exist-ing networks and leadership.

• Particularly need individu-als who speak their native language.

• Need indigenous planners and practitioners to estab-lish trust with communities.

• iD+Pi’s presence in UNM SA+P enables connection to an existing and growing ac-ademic network of Commu-nity and Regional Planning graduates.

educAtion And empoweRment

• Create access for commu-nities to participate in plan-ning for their own futures

• Community visioning pro-cess and “Planning 101” workshops establish com-mon vocabulary, goals, and set of expectations for all collaborators

• Contribute to the training and education for future generations of indigenous professionals in planning, ar-chitecture, engineering, etc.

• Addressing environmental and social justice for exploit-ed communities and popu-lations

Partnerships exist with commu-nity leaders, which are typically initiated by the communities themselves.

community pARtneRships

• Zuni Youth Enrichment Project

• Zuni Pueblo MainStreet• Red Water Pond Road

Community Association• A.C.E. Leadership High

School• Pueblo de Cochiti Education

Department.

institutionAl pARtneRships

• UNM School of Architecture + Planning

• UNM Stem Collaborative• STEAM NM• New Mexico Mathemat-

ics, Engineering, Science Achievement, Inc. (NM M.E.S.A.)

• NM Tribal Planners Roundtable

• Surdna Foundation’s Thriving Cultures Program

• ArtPlace America• McCune Foundation• American Indian College

Fund• Sustainable Development

Institute, College of Menom-inee Nation

• Navajo Technical University• Southwestern Polytechnic

Institute• Institute of American Indian

Arts• Santa Fe Leadership

Institute• Indian Pueblo Cultural

Center• Sustainable Native

Communities Collaborative• Faculty of Architecture, Uni-

versity of Manitoba• School of Community and

Regional Planning, University of British Columbia.

Meaningful engagement with historically exploited communities often leads to disclosure of deeply rooted traumas and dysfunc-tion, and practitioners must be emotionally ready• Indigenouspractitionersarekeyhere:extradegreeofconfi-

dence.• However, more trust comes with some liability: potential for

backfireifoutsideindigenouspractitionerfailstorecognizeaneed or nuance of the community.

Difficultiesintransitioningfromvisioninganddesigntoimplemen-tation. It will take generations to fully realize some plans (for fund-ingreasonsaswellasbydesign) Capacitybuildingcouldbenefitfromstrongerorganizationalsup-port on a national level

• Increased advocacy for indigenous and tribal planning from orgs such as APA

• More expedient ways to navigate bureaucracy (via IRBs, for example)

• Necessity for the training and support of indigenous and mi-nority practitioners to work within their own or representative communities.

• Cultivating community engagement and connectivity as core aspects of planning processes.

• Maintaining a view of community and public health which in-cludes cultural resiliency and histories of systemic violence

Theodore Jojola, PhD, Founding Director, Regents’/Distin-guished Professor of Community and Regional Planning.Phone:(505)277-6428Email:[email protected]

Michaela Shirley, MCRP, Program SpecialistOfficeLocation:P137,GeorgePearlHallPhone:(505)277-4493Email:[email protected]

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DATA COLLABORATIVE

Case Study :NEW MEXICO COMMUNITY

The New Mexico Community DataCollaborative(NMCDC)is a network of public health advocates and analysts from over a dozen state agencies and non-government organizations who believe in the value of community health assessment. Community Health Assessment is the intersection of public health surveillance and community organizing. The project grew out tremendous demand for sub-county level data from both public agencies and community advocates. In 2006, it was an integral part of the Place Matters movement and its local affiliateinBernalilloCounty,and expanded its focus to provide data to assess geographic, income and racial/ethnic disparities. In recent years, it has expanded to serve all New Mexico counties and communities with emphasis on local health impact assessments, and broad issue areas such as early childhood health and education, food security and obesity, public services and the built environment.

Serves as a resource, enabling stakeholders across the state to

access and understand data. BUILDS community capacity to move

data into action. Types and examples of planning

& and health-related mapping activities include: projects

developed by planning or health professionals; projects developed

by non-planner community organizations; and applied research

to address community assessment across sectors.

WHAT?

Capacity limitations.

NMCDC aims to engage a wide variety of stakeholders in map-ping and trainings, particularly those from government agen-cies,non-profitorganizations,community advocacy groups, schools, and other profession-als.AsofJuly2017,over90people are creating projects on the NMCDC platform and many more are actively accessing

information on this collaborative data commons.The types of groups currently working on planning- and health-related mapping projects and involved in trainings include: community groups, students, health professionals, providers of direct services, and planning professionals.

Any healthy community design issue could be addressed. Top-ics of focus for NMCDC to-date have related primarily to social determinants of health, includ-ing: food insecurity; early child-hood development; education; access to health care; air and waterquality;trafficsafety;obe-sity; physical activity; availability of parks and trails; oil, gas and mining industry.

Focus on Neighborhood (sub-county)data;Statewidecoverage for most data sets and trainings; regional and national datasets also included in some cases.

The primary goal of NMCDC is to build community capac-ity to move data into action. Action means informing evi-dence-based decision making in New Mexico, planning and improving health, education, and other service delivery, evaluating interventions and systems, and informing policy decisions.NMCDC works toward this goal through a few key mechanisms:

1)Datawarehouseandinterac-tive website at ArcGIS Online where analysts and advocates share datasets from multiple sources. The interactive func-tions of ArcGIS Online facilitate group exploration of health and other issues. The NMCDC online data warehouse currently houses over 400 neighborhood level data sets with over 1,600 variables.

• The maps are being used to facilitate group discussions, participatory data explo-ration and collaborative decision making. Users are incorporating the data and the maps into community health council assessments, grant proposals, public health program planning and management, health im-pact assessments, and policy debates.

• Any visitor may explore the maps interactively: turn vari-able layers on or off, zoom in and out to different neigh-borhoods or regions, click on an area of interest to see

its statistics, and view tablesof variables. Subscribers to the site can upload and store their own data, make maps and ap-plications,usefilesandfeaturesshared by other collaborators, and copy, modify and save ex-isting maps.

2)TrainingandMentoringusers:NMCDC offers training work-shops, access to consultation with GIS experts, and personal assistance and mentoring to any user or subscriber with no obligation to pay.

• The introductory level, “The Map Facilitator,” trains participantstofindandexplain(orextract)dataonthe website and facilitate participatory decision mak-ing, create reports, or inform grant writing.

• The advanced level, “The Map Maker,” is for ArcGIS subscribers to build custom maps from existing features and download master data-setsforprofiledevelopmentor in-depth analysis.

• Since November of 2011, collaborators and staff have conducted 40 workshops attended by over 450 peo-ple from primarily the gov-ernmentalandnon-profitsectors. Many of these new users have introduced the website to their constituents and used it to facilitate par-ticipatory decision making forpublicbenefit.

Funding

NMCDC has been supported by the following organizations: McCune Charitable Foundation, Con Alma Health Foundation, New Mexico Department of Health Public Health Division Regional Epidemiologists and Health Promotion Teams, New Mexico Department of Health Community Health Assess-ment Program, New Mexico Alliance of Health Councils, Thornburg Foundation, Rio Grande Community Develop-ment Corporation, Santa Fe Community Foundation Health Equity Partnership, New Mexico Early Learning Advisory Council, Presbyterian Health Services, and New Mexico Voices for Children.

• Access to data points (see Partnerships,below)

• Funding for staff time, plat-form access and manage-ment

• Staff and volunteers with ex-pertise in data, systems, etc. more generally, and at least familiarity with content areas such as health

• Demand from existing or potential users, as the ap-proach is demand-driven

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NMCDC also shares agree-ments of trust with multiple state and local government agencies. This allows access to data,oftenofaconfidentialna-ture, that can then be submitted to the labor-intensive process of geocoding and aggregation, under departmental protec-tions. Only then can the data be used and shared for community assessment purposes.

plAtFoRm development: As part of the NMDOH Com-munity Health Assessment Program, which includes the Indicator Based Information System(NM-IBIS),NMCDChaspromotedandisnowbenefitingfrom the development of major geocoding projects that are standardizing quality and meth-ods to process more databases in aggregated geospatial for-mats. Thanks to funding NMC-DC assisted in acquiring, NM-IBIS has adopted the interactive mapping and collaborative sharing functions pioneered in NM by NMCDC.

keeping pAce with demAnd:Geocoding datasets, creat-ing maps, maintaining current links and data are all time-con-suming processes and require certain skills and training. Al-though NMCDC has a network of skilled professionals who can help centrally, consistent funding has not been available to dedicate resources to keep pace with demand.

community cApAcity

Most stakeholders come to NMCDC with great interest but limited skill level, time, and re-sources to engage with and cre-ate maps and data sets. Overall, capacity is being built around the state, but there is potential for so much more.

mindset Aside from the relatively few eagerandconfidentpartici-pants, most people NMCDC has worked with do not think of themselves as capable map-pers. Overcoming this mental barrier needs to occur before more tactical and practical skills can be taught.

• Those who have worked with NMCDConaspecificproj-ect or more generally speak to the value of NMCDC serving as a one-stop-shop for many data sets in one, flexibleframework,theabili-ty to layer and visualize infor-mation in an interactive way, and the complementarity of capacity building trainings and customized mentoring.

• Users of NMCDC’s services also speak to the value of: discovery by exploring data in open-ended way; seeking answers to more targeted questionsonspecificissues;and using data and maps to communicate in a more compelling way.

• Accessing, visualizing, and comparing aggregated data on more detailed scales (by census tract, school district, other administra-tive boundaries, and even site-specificforschoolsandotherlicensedfacilities)isinvaluable for many. While many resources exist to access and visualize county level data, there is no other singleagencyorofficeinNew Mexico that manages a comparable quantity of sub-county data.

• Users of data are better informed about its value than are keepers of data. NMCDC acquires, develops, and shares data only when requested by one or more viable organizations who havebeneficial,realworlduses for it.

• Statewide Data is most valuable: all databases are developed for every neigh-borhood in the state; state-wide tools are reusable and provide economy of scale. That NMCDC is state wide helps people trying to do similar things in different locations.

Tom Scharmen, [email protected], (505-897-5700x126)

http://nmcdc.maps.arcgis.com/home/index.html

Greenprint Project

Case Study :Bernalillo County

The Greenprint project is a planning process undertaken by Bernalillo County and facil-itated by the Trust for Public Land(TPL).Theprimarygoalis to develop a conservation plan that provides direction for the use of public funds for conservation projects through-out Bernalillo County. This includes acquisition of future open space, recreation, and farmland areas, as well as ad-ministration and maintenance of existing County open space sites.

To develop a list of priority conservation areas, the proj-ect used both a technical committee, as well as multiple publicmeetings,torefinetheprimary evaluation criteria. Five goals emerged out of thisprocess(seebelow)whichthen determined the evalu-ation criteria that were ulti-mately used. Using the best available GIS data, the Trust for Public Land developed a series of maps thatidentifiedpriorityconser-vation areas based on these criteria.

These maps were developed as both standalone and as composite maps, with criteria combined to come up with a list of priority sites.

In the long term, the assessment will provide County staff and deci-sion makers with a useful tool to

talk about and plan for future open space acquisition and management.

Through the planning process, it also gave stakeholders from over

30 public agencies (inhabiting a variety of professional roles and networks) the opportunity to de-

velop a collaborative conservation plan that meets multiple goals.

WHAT?

Data for decision making; net-work shortcomings; community engagement methods; policy formation and implementation.

The project involved a communi-ty-led assessment of priority open

space and conservation areas in Bernalillo County, using both a technical committee, as well as multiple public meetings and a

survey to gather feedback from community members. The assess-ment fulfilled a clear, practical

need for Bernalillo County to objectively evaluate the benefits

of different acquisition strategies of future open space areas.

GreenPrint Map.

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The target group is all residents of Bernalillo County, especially those who may have limited access to open space and rec-reationareas.Morespecifically,the plan is a guide for County staffandelectedofficialstohelp determine priority acquisi-tion sites in the future.

Access to open space, trails, recreation, and preservation of agricultural land. The assess-ment emphasized the multiple benefitstoconservationofnat-ural areas including ecosystem servicebenefits,preservationofcultural landscapes, access to open space and recreation, and habitat protection.

The assessment covered all of Bernalillo County. However, the Trust for Public Land has com-pleted Greenprints for several other counties and regions around the United States.

Five goals emerged out of the public process, each weighted accordingtoidentifiedneeds:

1. Protect Water Quality in Riv-ersandStreams(30%)

2. Protect Wildlife Habitat (22%)

3. Preserve Local Agriculture andFoodProduction(18%)

4. Protect Important Cultural andHistoricalSites(15%)

5. Provide Public Access to Healthy Outdoor Recreation (15%).

These goals formed the core priorities for the assessment and were used to produce draft andfinalmapsofconservationareas within the County. They were also used to guide the public conversation around this plan, as it was recognized early on that conservation within Ber-nalillo County was about more than protection of natural areas. Instead, it was clear that pres-ervation of cultural and histori-cal sites, including agricultural land, was just as important to residents. In addition, access to these sites as well as recreation opportunitieswasidentifiedasa key need from the beginning of the public process. Through-out, there was an emphasis on holistic assessment that con-sidered the health of the entire County.

The impetus for this plan grew from a mill levy increase that was approved by Bernalillo County residents in 2014. This mill levy directed funds to open space conservation projects around the County. However, at the time, there was no plan in place as to where these funds should be allocated. Following the passage of the mill level, the County completed a Parks, Recreation, and Open Space (PROS)Planin2015thatrecom-mended conservation areas be identifiedinthenearfuture.TheGreenprint provides the plan andtoolstofulfillthisrecom-mendation and help staff and the County Commission decide where to invest mill levy funds.

Further, this plan was facilitated by access to available GIS data-sets about both natural and hu-man systems within the County, as well as the success of other Greenprint Projects around the County.

Bachechi open space plan

Stakeholders from over 30 public agencies were involved in this effort, as well as mem-bers of the public. Representa-tives included staff from other local and state agencies such as AMAFCA, and the National Park Service, as well as repre-sentativesfromlocalnon-profitand advocacy groups, including those interested in agricultural preservation, historic preserva-tion, habitat restoration, and access to recreational opportu-nities.

The strongest partnership that made this project possible is the collaboration between County staff and staff from the Trust for Public Land. In this case, the County was able to engage the TPL’s expertise and experience with Greenprints around the County and apply it to Berna-lillo County. This expertise was invaluable, as the County did not have the expertise or knowl-edge in-house to complete this assessment on its own.

One partnership that this pro-cess could also help strengthen is between Bernalillo County staff (especially from the Parks andRecreationdepartment)and their colleagues at the City of Albuquerque. Because the Greenprint covers all of Bernalil-loCounty,itsassessmentfind-ings may also prove useful to the City of Albuquerque.

Key challenges included initial data acquisition, generating interest in the planning process, and communicating the impor-tance of the project to ordinary residents. As with other proj-ects, getting everyone to the table was a challenge although the County had in place an ex-isting network through staff rela-tionships across departments and agencies.

Because the Trust for Public Land has performed similar Greenprint assessments in other places, their exper-tise and planning process was crucial to making this project a success. Although the County had in place a Parks, Recreation and Open Space Plan, and a mandate to use funds raised by the mill levy, it did not have clear guidance on where and how these funds should be pri-oritized. This project guided the County to synthesize the goals of multiple stakehold-ers while also creating a tool that can be used for future decision making. Ultimate-ly this process validates a model of community involve-ment that considers multiple perspectives, priorities, and values and combines this with a robust evaluation method-ology that allows everyone to visualize and discuss costs andbenefitsinaholisticmanner.

John Barney, Parks Planning Manager, Bernalillo County, [email protected] Morris, Conservation Vision Program Manager, Trust for Public Land, [email protected]

moRe inFoRmAtion

http://www.bernco.gov/commu-nity-services/greenprint.aspx

http://web.tplgis.org/BernCo/

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HEALTHY HERECase Study :

Healthy Here is an initiative of the Bernalillo County Com-munity Health Council. It is funded through the Center for Disease Control and Preven-tion’s REACH (Racial and Eth-nic Approaches to Community Health)awardandmanagedby Presbyterian Healthcare Services. The initiative is a co-alition of many partners in the community (see below for a morecomprehensivelist)whooperate through a collective impact model, sharing a com-mon vision for change and commitment to collaborative and joint approaches to enact-ing solutions through agreed upon actions. The Healthy Here program seeks to reduce and eliminate racial and eth-nic health disparities through strategies across:

1)policy(landusepolicy,schoolnutritionpolicy)

2)socialsystems(communi-ty, educational, food supply chain,healthservices)

3)physicalenvironments(street-level built environment, agriculture, recreation areas, food access points, garden spaces).

Collective impact model involving ongoing commitment and engagement

by a number of institutional partners ( grantees and sub-

grantees ) that complement one another in resources, assets, and

networks, and work toward shared goals.

WHAT?

Network shortcomings, funding and capacity limitations, lack of leadership and organizational commitment.

Two areas of Bernalillo County: the urban and rural South Valley (Hispanicpopulationfocus),andthe urban International District (Hispanic and Native American focus).Thisrepresentsaprioritypopulation of 55,456 people. To illustrate the inequity that exists in Albuquerque, consider that life expectancy varies by more than 22 years across census tracts.

Healthy Here: Communities Leading Healthy Change ad-dresses the risk factors of poor nutrition, physical inactivity, and lack of access to chronic disease prevention, risk reduction and management opportunities.

Current focus of partnerships and programming is on South Valley and International District communities within Bernalil-lo County. Lessons learned through Healthy Here are actively being used as part-nerships and programs are implemented across the state through health councils and the work of Presbyterian Healthcare Services Center for Community Health as they implement their community health plans in part-nership with communities.

goAls: The comprehensive approach being implemented (see strate-giesandactivities,below)aimsto increase access points for fresh, local produce and reduce economic barriers to their con-sumption; improve awareness and opportunities for physical activities – especially building infrastructure to increase walk-ability; and spread successful prevention and self-manage-ment tools and provider training for chronic disease.

outcomes: 1)increasednumberofpeoplewith increased access to physi-cal activity;

2)increasednumberofpeoplewith increased access to healthy food or beverages;

3)increasednumberofpeoplewith increased access to preven-tion, risk reduction and chronic disease management opportu-nities. All three of these out-comes aim to reach 75% of the prioritypopulations,or41,592people.

stRAtegies:Safer Environments for Physical Activity: The Coalition’s strat-egies for increasing physical activity include encouraging people to get outdoors and walk by offering clinical pre-scriptions, through media cam-paigns in various settings, and involving residents in improving the walkability and safety of their neighborhoods.

Access to Healthy Food and Beverage Options: The Coa-lition’s strategy is to work at multiple levels of the local food system (e.g. production, dis-tribution, consumption, and education)toincreaseaccessto, and consumption of, healthy food in priority communities. This includes working with agricultural coops, communi-ty-supportedagriculture(CSA),farmers’ markets (including the MobileFarmersMarket),schooland community gardens, and nutrition education.

Community and Clinical Link-ages: The Coalition's linkage strategy for addressing chronic disease disparities is to connect healthcare sites and community access points for chronic dis-ease self-management pro-grams, opportunities to increase physical activity, and healthy and affordable produce. This is primarily accomplished through the Wellness Referral Center (WRC)tofacilitateandtrackreferrals from clinical settings to community activities, and also involves training community health workers, healthcare pro-viders and community leaders, with the support of a dedicated Clinical/Community Linkages Coordinator.

The partners at the table in all three of these components are experts in working with mem-bers of the priority populations and bring information on cultur-ally appropriate ways to engage with these communities. As drivers of this work, they help to ensure that the communities are engaged in an appropriate manner throughout the

• Mutually reinforcing nature and inter-related structure of each of the three strategies. For example, the primary program of community/clin-ical linkages, the Wellness ReferralCenter(WRC),gen-erates referrals from medical providers to services like the Mobile Farmers’ Market (i.e., one of the primary programs ofaccesstohealthyfood),as well as walking trails (i.e., one of the built environment foci of the active living initia-tiveinHealthyHere).

• Dedicated staff (backbone, administrativesupport)andinfrastructure to enable continuous coordination. Through the program’s regular operations and lead team meetings, as well as an online platform for in-ternal communication and an internal e-newsletter, there is consistent and open communication among partners. Also, Healthy Here backbone support includes resources to support and coordinate across the needs of the entire program and its collective partners.

• Funding to support staff and implementation of all of the activities.

planning, implementation, and evaluation of the program.

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• Funding from the CDC REACH cooperative agree-ment is temporary and influencedbyfederalpolicy,which affects core opera-tions and sub-awardees. Additionally, partners’ fund-ing from other sources is not consistent from year-to-year, which has led to some chal-lengesinstaffingandimple-menting projects.

The above organizational chart represents the key partners and lead team members. It was current as of 2016 and is in the process of being updated.

• Staffingamongmembers of the Healthy Here extended team has not always been consistent or sufficient.Staffturnover (espe-cially among communityhealthworkers)andstaffingcutsamongpartners hurts the initiative’s progress.

• Wewouldbenefitfromaddi-tional community awareness and an understanding of its function in communities. Related, consistent en-gagement and participation in efforts by all extended members of the partnership would aid the initiative.

• To support the sustainability of such a large initiative, it has been important to align organizational structure and branding with a primary co-alition responsible for com-munity-wide health assess-ment and planning – in this case the Bernalillo County Community Health Council serves that purpose.

• The initiative’s plans and activities are relevant and meaningful to communities because they are driven by the community coalition that consists of the commu-nity partners with expertise about the strengths and needs of their communities.

• The initiative’s structure and processes (multiple but overlapping sub-groups, regular reporting and meet-ing)facilitatescross-learningamong partners, community members, and different pro-fessionals, which has been important for realizing the collective impact model.

• The alignment with Presby-terian Healthcare Services and the Affordable Care Act requirementsfornon-profithospitals to complete com-munity health assessments and implement improve-ment plans has created an essential backbone function that has supported program implementation and Healthy Here program adminis-tration. This has provided financialandstaffresourcesthat have been key to the success of the program.

• Partnership with diverse community organizations including regional planning entities, school districts, non-profits,farmers,andhealth care providers have brought an important lens to health improvement work and allowed for the work to be more successful.

• Work related to the Physical Activity strategy, in particu-lar, has been an important vehicle for cross-sharing and learning among planners and public health profes-sionals, especially between MRCOG and other partners.

BernalilloCountyCommunityHealthCouncil(BCCHC) Tiffany Terry, BCCHC Healthy Here Program Specialist site: bchealthcouncil.org/healthyhere email: [email protected] (505)246-1638 Facebook: www.facebook.com/healthyherenm

Leigh Caswell, Principal Investigator, Director, Presbyterian Center for Community Health 505-724-8865 [email protected] www.phs.org

• A strong partnership with the UNM Prevention Re-search Center has facilitated effective program evaluation that has led to strengthened initiatives.

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DOÑA ANA COMMUNITIES UNITED CHAPARRALLISA DRIVE CONNECTIVITY

Case Study :

PROJECT-ENGAGEMENT

Doña Ana Communities United (DACU)buildsthecapacityofcommunities to develop and implement policies and commu-nity-based solutions that improve social, economic, and environ-mental conditions that shape health and life opportunities.

We work to advance health equity in Doña Ana County by addressing institutional inequi-ties related to geography, class, gender, and race.

Currently, DACU’s two primary projects are the timebank and participatory social equity map-ping.

The Las Cruces timebank (hOurTime)isacommunitynetwork that helps members exchange free services with one another. Research shows that such networks can build social cohesion, decrease loneliness, and have positive impacts on health. The goal of the mapping project is for community mem-bers to engage with Las Cruces Citystaffandelectedofficialstobring health inequities as well as community assets to light.

Together, all stakeholders then work to develop solutions that advance health equity.

In spring 2017, DACU received a grant from the New Mexico Re-siliency Alliance and Plan4Health NM for the Chaparral Lisa Drive Connectivity Project.

The project focuses on devel-oping the capacity of Chaparral residents to inform land use plan-ning and to engage with Doña Ana County staff and elected officialsastruepartners.Astheyexplore their community’s trans-portation patterns and dialogue about them with decision mak-ers, residents develop the capac-ity to utilize their many gifts to shape their community’s future.

Grant funding enabled DACU to collaborate with the County on a grassroots public engage-ment process to inform devel-opment of a multi-use trail along Lisa Drive. Funding for phase one of the trail was secured, and construction is scheduled for September 2018.

Practicing and institutionalizing a new approach to community

engagement in land use planning.

WHAT?

Community engagement meth-ods.

The 20,000 residents of Chap-arral. Many of the diverse residents of this colonia are immigrants, and have been traumatized by illegal immigra-tion raids and largely ignored by local and state government.

DACU open house and TimeBank project

Chaparral, a sprawling and isolated colonia straddling the Doña Ana/Otero county border. Potential to apply approach to other communities as well.

• Address the priorities of Dona Ana County Com-prehensivePlan(Plan2040),which incorporates a number of measures related to health and equity.

• Benefitresidentswhowalk,cycle, and ride horses by incorporating their input into construction of a multi-use trail.Also,benefitallcommu-nity members by improving the siting of SCRTD bus stops, and reducing vec-tor-borne diseases by en-abling drainage of standing water.

Bilingual DACU staff have trained two Chaparral community mem-bers to engage the broader com-munity and conduct participatory mapping. As of this writing, key activities have included: many one-on-one meetings to share information about the project and gather input (with communi-ty members at their homes, with local school administration, and withclinicstaff),observingcom-munity members’ movements and activities around the trail route, and documenting chal-lenges and opportunities with photos and videos.

The project leads are also plan-ning a community walk along the existing trail, as a way to engage more people and gather more observations and input.

In response to high levels of in-terest among community mem-bers, the project leads are also compiling information to share with people who are interested in

becoming more involved; there is such great interest because, as community mem-bers have expressed, they feel thisisthefirsttimetheyhaveownership over a project that will impact their daily lives.

In fall 2017, the project leads (including community map-persandDACU)willworkwithan NMSU public health stu-dent to create a story map that incorporates data collected during the project and depicts thekeyfindingsbasedoncommunity input.

This will be used as a com-munications tool with all stakeholders, and one step in the process to educate coun-tystaffandelectedofficialsabout new community en-gagement methods.

• DACU’s existing networks and relationships with com-munity members, city and county agencies, and other key stakeholders, which serve as a basis for produc-tive engagement during the project and follow through in the longer term.

• Funding and partnerships for staff time and other nec-essaryresources(seebelow).

• The right people to lead the community engagement process -- in this case, dy-namic and connected mem-bers of the community who know how to communicate with each individual in a nu-anced, relevant way.

Improving public infrastructure and design to: increase physical activity; improve air/ water qual-ity; strengthen the social fabric of the community. Also, advance the resiliency of the community through: place-making; advocacy and organiz-ing; and capacity building.

Censusofpedestrians(July,September)

goAls

• Implement, and ultimately institutionalize, new commu-nity engagement methods in Doña Ana County and beyond.

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Given the project’s goals, a number of collaborations are necessary to not only build community members’ capacity, but also to seed lasting changes in the way community members and decision makers engage with each other going forward. DACU brings many existing partnerships to this project, including a strong relationship with the County’s Community Development Department as well as in-kind student support from NMSU and Doña Ana Community College.

• Enthusiasm for this project has been so strong among community members that it hasbeendifficulttomanageexpectations, as the process is slow and evolving.

• The funding was already secured for phase one of the multi-use trail, so community members were not brought in at the ground level. Still, because the project is inte-grated (it addresses multiple

• Instead of simply trying to build support for a proj-ect, it is important for the long-term success of such a process to objectively understand all community members’ perspectives – in-cluding concerns, questions, enthusiasm, and more.

• Some community sup-port for the project (in this case all community members seem to be enthusiastic, but unqual-ifiedsupportfromthestart is not required for ultimatesuccess).

issues, including drainage andpedestriansafety),ithasbeen very well received.

• Due to county law enforce-ment overstepping their bounds in the past in en-forcing immigration laws, distrust of local government continues in this community.

• While this has not been a major challenge in this case, engaging such an exten-sive variety and number of community members can bring to light very different attitudes about what shape such a project should take, whichcanbedifficulttonavigate and address during project implementation.

• It takes time to build trust, even with a thoughtful pro-cess and good intentions. This community has been part of many processes and projects in the past, many of which started positively but with results that did not meet expectations. While the approach to have com-munity members lead the engagement process in this case is working well so far, some remain skeptical or hurt by past efforts.

An accurate understanding will help to set and manage expectations appropriately, which is necessary for building and maintaining trust.

• Approach all interactions, with all stakeholders, as part of a longer relationshipbuilding process, rather than focusing narrowly on accessing a spe-cificresourceorgatheringaspecificpieceofinformation.

• It is important to convey information in different ways to different audiences. For instance, the type of informa-tion community members are interested in receiving, and the format in which it will be most compelling is different thanforcountyofficials. However in both cases, the project team is sharing infor-mation on an ongoing basis and soliciting feedback, rather than presenting everything at once and in a delayed man-ner.


Kari Bachman Director, Doña Ana Communities United E-mail: [email protected] Phone:575-496-4330


• Related to the above point, it has been most effective to use information as a way to support a dialogue, rather than sharing in a one-sided presentation format. It is condescending to assume that community members are the only ones who need to learn how to engage with government: county staff andelectedofficialsalsoneed to learn and practice new ways of engaging with community members.

• It is important to incorporate feedback loops into such a process.

• At the time of this writing the project was too early stage to speak to implications for institutionalizing a new com-munity engagement process in Doña Ana County and beyond, but please visit the DACU website as the project progresses.

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FIRST CHOICE COMMUNITY HEALTHCARE: Case Study :

SOUTH VALLEY COMMUNITY COMMONS

WHAT?

First Choice Community Healthcare(FCCH)strivestoprovide high-quality primary care services – maintaining wellness, early detection, and disease management in an outpatient setting. Several years ago, FCCH, along with several community partners, began to re-envision its approach to improve the health of community members in light of evidence indicating the health of individuals is inextricably connected to the communities in which they live, even more so than the health care they receive.

Understanding the need for a more comprehensive approach to improving health, FCCH and strategic partners developed a plan to address indicators that aim to leverage the role of medical care to contribute to long-term health and wellness in a holistic way. This plan was for a wellness ecosystem – the co-location and cooperation of complementary organizations and enterprises working toward community health – known as the South Valley Community Com-mons.

The key focus areas for the Commons include:

• Launching an affordable, high-quality child devel-opment center and day care, focusing on school readiness and linking with neighborhood seniors for social support.

• Providing educational opportunities for youth to access a high school diplo-ma through a partnership with Health Leadership High School, helping to create career pathways in the health sector, build the local workforce, and break intergenerational cycles of poverty.

• Expanding FCCH’s preven-tative health care model and providing opportuni-ties for graduate medical students to engage in community-based care, opening the training cen-ter to interested students after graduation.

• Enabling the expanded wellness model through a state-of-the-art wellness center,includingfitnessequipment, classes, and extensive walking trails on-site.

• Ensuring that students and community mem-bers have access to nutritious and affordable food through communi-ty garden plots, green-house, farmer’s market, cooking and nutrition classes, and a restaurant.

• Furthering economic de-velopment by recruiting additional commercial partners, for instance a credit union to provide accesstoqualityfinan-cial products for com-munity members.

Each of these areas involves partnerships that are struc-tured in a way to simulta-neously support FCCH’s and each partner’s mission, while maximizing communi-tybenefit.

Health care organization driving local transformation of built

environment and more to address social determinants of health and improve overall community health

All members of a community, particularly those that face sys-temic obstacles to achieve and maintain health and wellbeing.

Albuquerque South Valley, with aspirations to serve as a model in any other community state-wide and nation-wide.

Lack of leadership and organi-zational commitment; Network gaps

goAls include

• Address the root causes (suchassocialdeterminants)of poor health and per-sistent disparities in health outcomes in the South Val-ley, and eventually in other communities.

• Have a multiplier effect on community wellness: for every person that accesses these services, the entire familybenefits.

• Help people reconnect with place and space, and build on strong cultural and his-torical heritage of the neigh-borhood.

• Through co-location and cooperation, use the Com-munity Health Commons to invest in local enterprises that have the best hope of mitigating socioeconomic indicators that are repre-sented by low-income and educationaldeficitstogen-erate sustainable wellness in the community.

• Assess how these ventures work and model them for other communities.

As this initiative is actively under development, visit the website (below)formostup-to-dateactivities with each partner and each aspect of the Commons.

Regarding the replication goal, this model is currently being im-plemented, on a smaller scale, at the FCCH Clinic in Edge-wood. Several partnerships with government agencies and other local organizations are being developed to integrate the Health Commons with other community services and enter-prises.

• Vision and commitment by organization’s leadership to address the issue of commu-nity health more holistically and reimagine how to ad-dress persistent community health issues beyond the organization’s walls and typ-ical approaches. By setting a vision and creating space to be creative, the project has been able to grow and adapt to changing condi-tions over time, while staying true to the same goals.

• Buy-in by key partners who can come together to pro-vide holistic and comple-mentary services.

• Physical space (existing or abletobeconstructed)thatcan serve as a hub for a diverse set of activities and services.

• Site that is centrally-locat-ed in a community (both in physical location and in terms of existing relation-shipsandreputation).

• Some seed funding is re-quired to launch such an initiative, although as this endeavor has shown, ad-ditional funding can be acquired in phases as plans develop and milestones are reached.

• Timing and environment: other organizations think-ing about health in this way (e.g., Casa de Salud, UNM, Presbyterian);theycansupport each other and help influencethehealthecosys-tem more broadly.

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A diverse set of partners is crucial for this type of initiative. The key characteristic of those involved is they understand that eachbenefitwhenthegroupasawholebenefits.Keypartner-ships have included:

• Bernalillo County: leasing land to FCCH; partnering on walking trails to make physi-cal improvements to ensure ADA compliance; providing funding and services, such as repurposing part of the site.

• Agri-Cultura Network: FCCH provides subsidies for low-income patients to participate in CSA program; co-host Saturday healthy food cooking classes (70-80 peopleparticipateperclass).

• U.S. EPA Urban Waters Part-nership:asoneof19sites,FCCH receives resourc-es about obtaining water rights, water management, and more.

• MRCOG: staff conducted trafficandparkingstudies,and helped work with Coun-ty on zoning issues.

• Albuquerque Public Schools: collaboration with teachers and administration on vari-ous aspects of the initiative.

• National Parks Service: help with walking trails develop-ment.

• Valle de Oro National Ref-uge: collaboration on educa-tional programs and resourc-es for children.

• UNM School of Architecture and Planning: faculty helped to organize community-en-gaged design process for each part of the planned expansion; led master site visioning meeting with community members, repre-sentatives of different neigh-borhoods, and partners; and helped with architectural renderings of Health Leader-ship High School.

• Key funding partners to-date include: Bernalillo County, U.S. Economic Development Administration, New Mexi-co State Forestry, and local businesses and community members.

• Funding: despite some success pursuing grants and private contributions, securing the total project costofapproximately$20million has been a big chal-lenge. Funding has driven the speed of development of different aspects of the project, as well as partner prioritization. The farm (not includingthefoodhub)iscurrently the only aspect that is fully-funded, so in addition to continuing fundraising efforts, an emerging strategy is to pursue different forms offinancingfromcurrentpartners and bring on new partners that can fund their own work.

• Environment: necessary adaptations to environmen-tal factors can shift focus away from new initiatives. For instance, FCCH needs to respond to all the complex and moving pieces of health care reform, and continue findingwaystoservepa-tients without insurance who do not have other options. Additionally, the clinic has had to evolve in the current political environment, serv-ing as a safe space for many patients who are undocu-mented.

• Capacity and expertise: such a complex, multidisciplinary initiative required FCCH to bring new expertise to the organization and create many new partnerships to drive these efforts. While this isbeneficialinthelongrun,it strains limited resources in the near term.

Juan Lopez South Valley Community Commons Coordinator First Choice Community Healthcare Email: [email protected] Phone:505-873-7449

Dr. Will Kaufman Director of Community Health and Wellness First Choice Community Healthcare Email: [email protected] http://www.fcch.com/sv_expansion

Renderings of proposed new community commons

Renderings of proposed new community commons

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University of New Mexico School of Architecture+ Planning, Master of Science in Architecture

Case Study :

Health + Built Environment Track

Public Health and the Built Environment is a concentration within UNM SA+P’s Master of Science in Architecture pro-gram, a 3-term, non-professional research degree. This track is fo-cused on how built environment interventions—viaplanninganddesign—canfacilitateimprovedcommunity and population health. The concentration was formalized within the MS Arch program in 2014 with the support of faculty in both SA+P and UNM Health Sciences on the basis of existing relationships and shared interests in the role of the built environment and community planning in enabling or address-ing health disparities.

Training a new generation of practitioners who have a solid back-

ground in both design of the built environment and in public health

to apply in both their research and practice

WHAT?

Capacity and leadership lim-itations(practitionersqualifiedfor establishing and running research and initiatives which integrate health, planning, and design)

Graduate level students from all backgrounds. Currently a major-ity come from built environment backgrounds, with some excep-tions such as students coming from journalism or history. Mi-chaele Pride is working with the head of the BS in Public Health program to build in a track or concentration for Public Health undergraduates, to be launched within the next two years.

Research varies based on stu-dents’ interest, but generally examines architecture and design through the lens of the socialdeter-minants of health, and how inter-ventions into the built environment translate to health outcomes.

UNM SA+P graduate program draws students from all over the world

goAls

• Build stronger relationships between practicing profes-sionals in health and planning fields;trainprofessionalswhoare versed in methodologies, practices, and perspectives frombothfieldsofstudy

• Integrate perspectives on health into built environment studies in both seminar and studio settings, with an emphasis on designing for intervention in existing social determinants of health

Examples of recent research undertaken:

• Public schools, elementary education, childhood obesity, and access to healthy food

• Designofofficeenviron-ments and emotional health (stress)

• Addressing obesity in rural areas of NM with interven-tions to promote and support active transportation

• A student, Breanna Wagner, worked with First Choice Community Health on the community health commons currently under development in Albuquerque’s South Valley

A future goal is to expand col-laborative and community-driven research projects which connect students with opportunities to build partnerships and assist NM communities, and engage in funded research as a team.

• An existing set of relation-ships between faculty in SA+P and Health Sciences, which was in place from a previously existing dual de-gree program which trained planning students in public health issues

• A well-timed opportunity to formalize these relation-ships, and the interests of supporting faculty, into a concentration within an ex-isting degree program

• A recognition of certain mu-tual tactics and approaches betweenbothfields(forexample, using windshield surveys to assess neighbor-hoodconditions)

• Expanding on existing rela-tionships with Health Scienc-es, especially the Schools of Medicine, Pharmacy, Nursing, Population Health

• Developing program in the context of a network of like-minded health + design programs nationally: the program was accepted into the American Institute of Architects’ Design + Health Consortium in 2017, connect-ing UNM to peer institutions and initiatives.

• One goal is to develop more private partnerships with architecture, design, and de-velopmentfirmstoconnectresearch to existing projects

- HDR: collaborate to study outcomes of an intentionally design healthy community in Colorado.

• Challenges involved in building and managing a new program include lessons learned about course load and sequence, faculty com-mittees and oversight, tack-ling dual-degree majors, and negotiating entry into Public Health courses

• Finding employers and developing a broader profes-sional culture which accepts multidisciplinary research around health + design to be a relevant and vital strength ofanyorganizationorfirm

• Bridging administrative barriers which currently inhibit collaboration between disciplinesoncampus,find-ing common priorities and resources between SA+P and Health Sciences

• The Public Health + Built Environment track is a fairly unique program in the coun-try,butsignifiesagrowingtrend toward integrating the twofieldsofresearch

• There are signs that employ-ers are beginning to seek and appreciate the expertise cultivated by the program, andsomefirmsareevencreating research units to specificallyfocuseondesignand health

- Dekker Perich Sabatini’s research unit just hired a recent program gradu-ate.

• Prospects for partnerships, funding, and research op-portunities are promising for the future of the program andthefield

Michaele Pride, MAUD Professor, Concentration Coordinator SA+P @UNM

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ART INSTITUTE

Case Study :SANTA FE

Facilitation of an interdisciplinary research residency for artists

and activists which fosters collaboration and networking

between disciplines, with an emphasis on equity and social justice

WHAT?

Language and communication; network shortcomings; funding

(communicating across dis-ciplines; challenge to silos in conventional methodologies;

sponsored community en-gagement and public dialogue

throughartisticpractice)

• Local communities: “bring the world to SFAI and SFAI to the world”

- Intergenerational local audience.

- Youth programs.

-Non-profitandactivistnetworks.

- Seek to reach beyond San-ta Fe: northern New Mexi-co, academic communities, regional organizations dedicated to social justice and equity.

Artist and activist community who are engaged in advocacy:

• Approximately 1/3 local, 1/3 national, 1/3 international

The artists-in-residence each havespecificresearchinterests,and are chosen in cohorts ac-cording to themes: • 2016-17 Water Rights: envi-

ronmental justice, fracking• 2017-18 Equal Justice: in-

cludes environmental justice, disability rights, urban plan-ning, community health and access to health care

• 2017 Design + Immigration: short-term residency for local designers

Additionally, the program manager hopes to program a residency in the future focused morespecificallyonhealthcareand access.

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Santa Fe Art Institute’s artist-in-residency program is now in its fourth year, themed around social justice issues.

From September through July each year, the program hosts 70-80 artists and practitioners for a sponsored interdisciplinary residency focused on research, project development, and public engagement.

The program’s thematic focus prioritizes conceptual work over conventional artistic practice, and so draws a diverse array of practitioners and disciplines, including civic lawyers, urban planners, activists, and educators, to name a few. Up to 11 participants at a time reside and work together in SFAI’s facilities, where the shared space supports a culture of collaboration. Residents are sponsored by SFAI and supporting funders, broadening capacity to include individuals who might normally be unable to participate in a research residency.

1/3 local, 1/3 national, 1/3 inter-national residents.Santa Fe-based, with many proj-ects which connect to statewide organizations and rural commu-nities, communities throughout northern New Mexico, and tribal and pueblo communities.

goAls

SFAI staff work to develop each successive year’s theme with input from current residents. Themes are developed in re-sponse to current conversations and events on both local and global scales. Transparency in process is a priority, and SFAI works to select a diverse jury who will in turn select next year’s resi-dents, whose names and bios are released with the call-for-entry. The residency prioritizes resi-dents who demonstrate risk-tak-ing, community connection, and diversity of personal experiences, ratherthanresidentswhofitaconventional bill of profession-al artistic experience (such as having an MFA, a material studio practice, or gallery representa-tion).

During the residency, SFAI acts as an “incubator space,” where residents can step back from the so-called “trenches” of daily lives, full-time jobs, and advocacy work to develop ideas and projects, as well as to complete existing projects. Residents share com-mon living space, research space, and studios. SFAI is a research rather than production residen-cy, allowing residents to explore partnerships and projects without pressure of a looming exhibition deadline. Projects take on many forms, with a large emphasis on public outreach and events pro-gramming.

Residents have the opportunity to work closely with local orga-nizations and are encouraged to develop relationships with community partners and with their fellow residents. The resi-dency is designed to be mutually beneficialtobothvisitingartistsand to local communities. Many residents from out-of-state have existing ties through previous projects, while other local resi-dents can organize around spe-cificchallengeswiththeaddedsupport of SFAI’s resources. The public programming targets spe-cificaudiencesbeyondtypicalmuseum-goers, and provides accessible programs which com-munitiesbenefitfrom.

As each year’s theme winds down, and during the gap be-tween residencies, SFAI coor-dinates a community project to synthesize some of the themes, interests, and genres which have arisen during the residency.

Community organizations and key residents are then identifiedtoworkinconcerton developing these themes into a project. For Immigra-tion/Emigration, SFAI part-nered with Santa Fe Dreamers, Alegre Love, and Design Corps to create a publication with stories, statistics, and which folded out into a map.

While SFAI has an open-door policy and regular open hours, its physical location makes it slightly inaccessible to community members who are not intentionally seeking to go there. One future goal is to create opportunities for people to stumble upon SFAI programs in public through pop-up spaces and off-site events.

• Granting organizations:- Andy Warhol Foundation- Americans for the Arts- Alliance for Artist Commu nities- Creative Access Fellow ship- Nielson Foundation- McCune Foundation

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• A board with all local leader-ship comprising local design-ers, architects, professionals

• Exchanges with organizations who support or fund a place in the residency (not all resi-dents are part of social justice theme):

- Greek Fulbright Foundation: JanuarywithseearrivaloffirstGreek Fellow

- Canada Council of the Arts

- Taiwan Ministry of Culture

- Rasmussen Foundation: reciprocal exchange with Native Alaskan, Native New Mexican

- Harpo Foundation: one emerging artist for one month each year

• Community organizations partner with residents and for one wrap-up project each year

• Many residents form long-lasting relationships with communities, organi-zations, and collaborators while in residence, and con-tinue to return and develop these relationships.

• Challenges in engaging different communities, developing long-term and meaningful connections with individuals and organizations

• Siloing within Santa Fe’s arts community, as SFAI’s ap-proach differs greatly from a larger commercial gallery culture

• Local connectivity: popula-tion turnover in Santa Fe

• City isn’t conducive to young-er people maintaining long term residency

• A lot of programming around youth, underserved popu-lations, but there’s a gap in services and engagement with younger adults and mid-dle-aged people

• Dependency on annual funding and grants: con-stant search for funding and renewal processes consume personnel time and resources

• In the past, limited funding hasplacedafinancialburdenon residents, and affected the overall demographics of participation.

• Signage and branding: dif-ficultyinseparatingidentityfrom neighboring university and other local organizations with whom partnerships exist

• Physical location often limits contact with community: spaceisdifficulttofind,andevents-based programming has been more effective at drawing in a larger public than has the open door policy

• Shared spaces and the op-portunity to develop social connections through person-al, informal interactions act as a catalyst for collaborations and networking on local, national, and international scales

• Coordinators see the SFAI model as part of zeitgeist in the art world, artists and institutions are shifting away from object-based gallery paradigm toward practices which engage in more press-ing conversations with com-munities - Increasingly common for minority populations to lead conversations and projects around structural oppression, using arts in-stitutions and practices as an organizing opportunity.Success of various cross-disciplinary partner-ships developed through residents’ efforts suggests the potential for art insti-tutions and organizations to assume a larger role in developing and strength-ening networks, and in stimulating communi-ty-led conversations and initiatives

• Likeanyfield,acertainamount of siloing exists; there are myriad challenges relat-ed to developing a different culture around and perspec-tive on the role artists and arts institutions can play in com-munity organizing

Toni Gentilli, SFAI Residency Program Manager Kourtney Andar, SFAI Works Manager

Santa Fe Art Institute, Artist-in-Residence Program



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Conclusion & Recommendations


Conclusion Collaborative, integrated initiatives in planning and public health exist across New Mexico. By and

large, professionals across the state have embraced the principles and followed the trends of the healthy community design movement.

This movement is captured in the Summarizing the Landscape of Healthy Communities report by the Build Healthy Places Network and the Colorado Health Foundation as “leading sectors, particularly community development, healthcare, planning and public health are beginning to work closely together through capacity building and investment demonstration programs to build coalitions, implement projects and programs, and share lessons learned.” Stakeholders from various sectors in New Mexico recognize the importance of work-ing together, and have been able to leverage limited resources and overcome substantial obstacles to address community health issues. However, with the breadth and depth of health challenges that commu-nities across the state face, there is room to improve our understanding

of the impact these collab-orative efforts have, and in turn make further improve-ments in community health outcomes.

In the following pages we identify pressing questions we believe need to be addressed, and recommenda-tions for addressing them. These recommendations are based on our understanding of the landscape from this assessment project, including crucial input by all of the stakeholders who participated in our regional events during the spring of 2017 and our roundtable event in July 2017. Given the inter-related nature of the issues covered, the recommendations are intentionally inter-connected and overlap in some cases.

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Photo Credits : Cycles of Life , Henry Jake Foreman • YouTube Still Image, chile pepper farmer


PUBLIC MEETINGS & WORKSHOPS

help mantain your community healthy throughout the state supported by coali-tions of planners, public health professionals, and other key stakeholders

Be part of the changeSURVEYVisit our website to complete our brief online survey and provide input on existing issues, assets, gaps, and data sources related to designing healthy commu-nities in your community. This will inform the state-wide assessment

EVENTSStarting in mid-April, we will host a series of events throughout the state to create opportunities for profes-sionals working on issues related to healthy communities, planning, and de-sign to provide their perspective on local issues and connect with others in their area. We will also host a larger roundtable in Albuquerque in July to share results from the project, workshop, and to network. Visit our website www.plan4healthnm.com to learn more about locations, dates and let us know if you’re interested in attending or partnering. COUNT YOURSELF IN !

If you are already creating change in your community through a project, partnership, or initiative that could serve as an inspirational and informative case study in the assessment, let’s talk!

ASSESSMENT

About P4HNMPlanners4Health is a six-month initiative to increase local capacity for creating stronger, healthier communities.The initiative focuses on promoting greater coordination between planners and public health professionals at the state level.The APA-New Mexico Chapter received a $50,000 grant (for the period February to July, 2017) to help build local ca-pacity for integrating planning and public health. The Planners4Health initiative is part of APA’s Plan4Health three-year, $9 million program to help communities combat determinants of chronic disease – lack of physical activity and lack of access to nutritious foods. Funding for the initiative is provided through a grant from the Centers for Disease Control and Prevention (CDC).Through the initiative, APA-New Mexico will use the grant funding to broadly share knowledge and resources so planners and public health professionals can help their communities more easily support and implement healthy living choices. The chapter will work to bring together key stakeholders, leverage existing healthy community initiatives and efforts underway, and share planning and public health information.

Edition: 03/2017 Publication number:1

Health & Planning Invest in yourself, your community Sign up & Get involved:: ::


Pressing questions & key recommendations

#1 Specialized Communication:

question

How can we cre-ate spaces where open dialogue can thrive, and lan-

guage is a bridge rather than barrier to connect key stakeholders from different sectors and professional backgrounds?

RecommendAtions: good pRActices

• Each person should recognize and mini-mize their own use of jargon

• Additionally, jargon such as Transportation DemandManagement(TDM)orTransitOrientedDevelopment(TOD)orSocialDeterminantsofHealth(SDH)asexamplesshouldbeclearlydefinedforallaudiences

• Make it a responsibility of planning and public health professionals to to tailor their messagesandfittheircommunicationstyleto different audiences with varying levels of knowledge

• Use visuals and graphics to help convey technical concepts

• Have humility, and acknowledge that there are multiple forms of knowledge and expertise

• Take a long view of change when com-municating with different stakeholders, acknowledging that it takes time to build trust and work through differences (includ-ingincommunicationstyle)

• Use technology to enable people to partic-ipate in meetings remotely

• Set agendas together at the beginning of a meeting, rather than having one person or group set the agenda ahead of time

• Create neutral spaces (physical or vir-tual)wherenoonegrouporpersoniscontrolling the meeting or marginalizing people from different perspectives

RecommendAtions: initiAtives/Activities/pRojects

• Create a glossary of terms that may not be readily understood by people from different sectors, professions, or education levels

• Create online repositories with “plain En-glish,” easy-to-understand public versions of community plans and policies

• Create mechanisms for people working in relevant areas to upload related pictures and stories online, and leave comments in response to plans and policies


#2 Organizational Commitment:

question

How can we lever-age the shared com-mitment and goals of multiple stakehold-ers, and shift some of the responsibility of

taking action and getting results from the indi-vidual to the organization/institution?


• Organizational leadership sets clear goals and ensures individual representatives understand and embody these goals

• Individuals are oriented to organizational mission/goals through training and knowl-edge sharing

• Individuals are empowered to act as lead-ers and participate in activities within the organization and broader networks

• Organize projects/initiatives according to the passions and interests of staff

• Identify individual leaders and provide training to build individual and organiza-tional capacity

• Document processes, outcomes, prod-ucts – for current and future staff to ensure consistency and continuity

• In organizational partnerships, create MOUs/agreements that formalize agreed upon principles and shared ownership of activities and objectives

• Recognize and reward successful efforts, and seek to build momentum by sharing success stories with partner organizations.


• Create training programs for organization leadership and other stakeholders that em-ploy the good practices highlighted above

• Organize and participate in events that take place every year to bring organiza-tions together around common issues (e.g. existing events such as the NM Infrastruc-ture Finance Conference, or new conven-ings)

#3 Capital and Financing:question

With the real funding constraints across the state – felt more acutely in some areas than others – how can we shift from competing for a slice of limited local resources to growing the pie for everyone? Also, howcanwefinancehealthycommunitydesignefforts in innovative ways?


• Work across county lines, state lines, etc. on shared issues to leverage additional resources

• Engage grant makers and business com-munity in discussions about the allocation of resources to bridge gaps between the priority focus areas of funders and local needs

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• Collaborate with partners from different sectors and areas to attract more substan-tial funding and other support from across the state or country, and pool matching funds for organizations with similar mis-sionsthatfulfillsharedobjectives

• Engage with community members to implement projects (as volunteers or re-cipientsofstipends)asameanstoengagelocal stakeholders in meaningful ways with the work and save on costs


• Implement participatory budgeting in local communities, which redirects a certain por-tion of public funds to community mem-bers’identifiedneedsandideas(https://www.participatorybudgeting.org/)

• Createopportunities(events,otherforums)to bring grant makers and seekers togeth-er for open dialogue about the funding needsacrossthestatetoinfluencefundingpriorities

• Community groups/agencies and edu-cational institutions should build stronger ties. For instance, community groups can leverage the following as resources: college/university students (for research projects,volunteering,internships);localpost-secondary campus branches (for space,technology,expertise);andlocalelementary through secondary schools (for community engagement, holistic service provision, pilot projects, and space/tech-nology/expertise).

• Non-profitsshouldleverageexistingresources across the state that focus on buildingnon-profitcapacity(e.g.TheGrantsCollective,CenterforNon-ProfitExcellence, Community Foundations, and more)

• Local organizations that serve as conveners should identify or organize trainings for organizationsonhowtofindandsecurealternative funding sources.

#4 Stability and Sustainability:

question:

What mecha-nisms can we put in place – at differ-ent levels – to en-sure successful or promising efforts can continue and grow over time?


• Shift away from hierarchical structures when working with communities, instead organizing relationships around com-munities(individualsandfamilies)--withgovernment(federal,state,tribal,county),non-profits,privatesector,andotherinsti-tutions providing surrounding support and services

• Ensure relevant cultural teachings, histo-ries, and practices are understood and employed

• Research and evaluate projects/efforts to enable feedback loops and inform future plans, to ensure sustainability of successful initiatives.

• Take a comprehensive view, acknowledg-ing how different sectors and stakeholders are or could be working together

• Take time to understand local community values and establish common ground to enable sustainability of community-based initiatives

• Engage a diverse set of actors, particularly those with strong community roots (such as faithbasedinstitutions)

• Implement documentation and training systems within organizations to enable stability when there is staff turnover

• Involve different populations in processes and identify community champions, for example youth

• Promote greater integration of holistic practices in research, particularly use of participatory research methods as part of research design


• Identify and catalogue local resources that are available, and make such a list available online and other formats for widespread use

• ForComprehensivePlans,trackfulfilmentof plan implementation through various community channels/outlets including the local government, local organizations and other responsible parties

• Host mapping workshops to visualize currently disconnected and unaggregated data.This is a way to build bridges between different stakeholders, build capacity in local communities, help set local priorities, and track trends in activities and outcomes over time

#5 Equity and Accessibility:

question

How can we address the persistent divides in capacity, access to resources, and investments between neighborhoods, rural, and urban areas, etc.?


• Given power hierarchies that exist, identify ways to make policymakers, leaders, and agencies more approachable and accessible to community members

• Pursue opportunities to build capacity in rural areas to more effectively access and utilize internal and external resources

• Apply lens of equity to all work

• Use existing tools to better understand and overcome myths and assumptions that reinforce the urban/rural divide and other differences (e.g. the Frameworks Institute hastoolkitsandotherresources)


• Leverage existing mechanisms (such as New Mexico Public Health Association annualpolicyforumandconference)topromote equity in policy making


• Hostforumsfocusedonspecificissues(such as upcoming New Mexico Public HealthInstituteregionalevents)

• Advocate for policies that make data and other information more accessible (with such access and awareness built among members of the public, issues can be bet-teridentifiedandadvocated)

#6 Policy:

question

How can we build stronger ties between communities and policy makers to ensure local implications of policy decisions are understood, and adequate feedback loops exist?


• Address community members’ perceived lack of necessary knowledge and educa-tion to engage with policy makers

• Remember that it takes time to build suc-cessful relationships with constituents

• Promptpeoplewithspecificideasandcourses of action, which is a more effective means for promoting action than sharing more generalized ideas

• Addressliteracy,language(s),abilities,andmore as potential barriers to participation

• Push for clarity and understanding by poli-cy makers and community members – this includes transparency, creating a common foundation of understanding, and space for everyone to ask questions

• Allow community members to have input into projects/policies/etc. before decisions are made, or priorities are set

• Encourage community members to run for localofficeandserveonboardstobetterunderstand government and policy from an insider perspective

• Build relationships with a goal of being able to provide mutual support when needed

• Invite policy makers to community meet-ings as guests, not facilitators

• Break down formal meeting structures that inhibit discussion (for example, need to sign up in advance for public comment sectionofcitycouncilmeetings)

• Provide stipends to community members for volunteer activities to incentivize mean-ingful engagement, and provide capacity building to these representatives


• Create a statewide cross-sector, interdisci-plinary rural policy working group



? ?

?

• Host workshops focused on strategic plan-ning, social equity, and other priority issues forcitycouncilorsandotherlocalofficials.

• Create opportunities for policy makers and constituents to connect outside of meet-ings or other formal environments

• Mandate training for incoming policy mak-ers (similar to orientation for state employ-ees)thateducatesandbuildsawarenessofassumptions and expectations regarding community engagement

• Leverage community health councils as go-to convener, sounding board, and resource for local priorities, activities, and contacts

• Use development of comprehensive plans as opportunity to strengthen existing connections and expand local networks in strategic ways

• Commitresources(funding,stafftime)tofocus on networking

• Organizations can promote a culture that prioritizes network building activities and operating as a positive actor in multiple networks

• Continually seek connections and partner-ships that are strategic, but also outside of your individual or organization’s comfort zone

• Support of leadership (from within an organizationand/ornetwork)isnecessaryto enable others to build stronger, more resilient network connections

• Create relationships that employ a collec-tive impact model (look to initiatives such asHealthyHereandothersforlessons)


• Host more regular conference calls and convenings of health councils from around the state

• Form an Inter-Agency Council to commu-nicate about meetings, programs, initia-tives

• Incorporatespecificnetworkexpansiongoals and targets as part of organization’s work plan

#7 networks: question

How can we better understand the assets that exist in our networks to betterleverageresourcesandfillgaps?


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#8 Community Engagement:

question

How can we better incorporate all voices and perspectives in planning, implementing, and evaluating initiatives?


• Acknowledge the differences between working in a community, with a community, and for a community: each can have its purpose, but requires different relation-ships and expectations

• Know the community/ies in which you work, and be sensitive to cultural relevancy

• Leverage social media, particularly to engage young community members in relevant ways

• Focusfirstongettingpeopletothetable,then engaging community members (and particularlyleaders)inlastingways

• Make engagement fun and interesting (e.g.involvefood,prizes,etc.)

• Ensure that all types of community mem-bers can access engagement opportu-nities (be sensitive to location, timing, outreach,etc.)


• Let community members run community meetings that are typically hosted by agen-cies – enables a more direct mechanism for community members to communicate priorities and share information profession-als may not have thought to look for

• Establish steering committees that include, and/or are driven by community members




Looking ForwardWe are at a pivotal moment in New Mexico to leverage the Plan4Health NM initiative

andfindingsforthecoalitionbuildingeffortslistedabove.Theserecommendationsmaybegintoaddresssomeofthechallengesidentifiedinthisassessment,andfurtherlever-age existing assets and resources. With the multiple and diverse perspectives represent-ed in these recommendations, we hope that any stakeholder in any part of the state will feel empowered to act on any of the ideas in a way that is most appropriate for their local context. In this way and through a commitment to further promoting integrated planning and public health initiatives, we believe improvements in community health can be made across the state.

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